Journal Sciences News
The Journal of Logic and Algebraic Programming
Available online 22 May 2018
A Normal Thyroid by Any Other Name: Linguistic Analysis of Statements Describing a Normal Thyroid Gland from Noncontrast Chest CT Reports
Publication date: Available online 22 May 2018
Source:Journal of the American College of Radiology Author(s): Ryan G. Short, Nicholas T. Befera, Jenny K. Hoang, Tina D. Tailor Purpose To determine the variability and readability of language used in chest CT reports to describe a “normal” thyroid gland. Methods Using a semi-automated process, we identified unique sentences or phrases describing a “normal” thyroid gland in 11,357 noncontrast chest CT reports. Readability metrics were computed for each descriptor, including sentence length and grade-level indices quantifying the education necessary for text comprehension. Grade-level indices included the Flesch-Kincaid (FK) grade level, Gunning Fog index (GF), Coleman-Liau (CL) index, automated readability index (ARI), and a computed composite grade level (CGL) calculated as (FK + GF + CL + ARI)/4. Results There were 342 unique “normal” thyroid descriptors identified among 6,957 noncontrast chest CT reports characterizing a normal thyroid gland. For these 342 unique descriptors, sentence length varied 23-fold, with a mean sentence length of 8.3 ± 5.1 words. CGL varied 4-fold, with a mean of 16.4 ± 4.5, suggesting that descriptors for a normal thyroid gland, on average, require an advanced college-level education for comprehension. Conclusions The language used by radiologists to describe a normal thyroid gland in chest CT reports is variable and complex. The linguistic characteristics observed herein may be a surrogate for the broader readability of radiology reports. With the growing role of the radiology report in patient communication, further linguistic analysis of reporting language may provide valuable insight for optimizing radiology communication.
Available online 21 May 2018
Risk Predictors for Postcontrast Acute Kidney Injury
Publication date: Available online 22 May 2018
Source:Journal of the American College of Radiology Author(s): Trudy Millard Krause, Maria Ukhanova, Frances Lee Revere, Kevin W. Finkel Objective To evaluate risk predictors of acute kidney injury (AKI) after contrast-media procedures in a broader cohort of patients than previously reported. Data Sources Comprehensive medical and pharmacy commercial claims data from 2012 to 2014. Data Collection and Extraction Methods Claims associated with contrast-media procedures for 2,737,020 persons between January 1, 2012 and November 30, 2014, were reviewed. Principal Findings The overall incidence of AKI after a contrast-media procedure was 0.85%. AKI occurred in 26% of cases that had two or more contrast procedures within 30 days, compared with 9% of non-AKI cases. Although the incidence of postcontrast AKI was low, 10% of patients who developed AKI had a recent previous episode of AKI. In cases when AKI had occurred within 180 days of contrast administration, the odds of subsequent kidney injury was 9.39. Conclusions Overall, there is a low risk (0.85%) of developing an AKI after a procedure with contrast-media consistent with several recent studies. However, in adults with a recent history of AKI, physicians must consider this history as a risk factor for subsequent AKI.
Available online 21 May 2018
Good Relationships Mean Good Reimbursement
Publication date: Available online 21 May 2018
Source:Journal of the American College of Radiology Author(s): Kurt Schoppe
Available online 21 May 2018
Ionizing Radiation Use and Cancer Predisposition Syndromes in Children
Publication date: Available online 21 May 2018
Source:Journal of the American College of Radiology Author(s): Janet R. Reid, Lisa J. States
Available online 19 May 2018
Estimated Mortality of Breast Cancer Patients Based on Stage at Diagnosis and National Screening Guideline Categorization
Publication date: Available online 21 May 2018
Source:Journal of the American College of Radiology Author(s): Samir B. Patel Purpose To compare overall and stage I to IV mortalities of patients diagnosed with breast cancer, calculated from stage at diagnosis using the Surveillance, Epidemiology, and End Results (SEER) database stage mortality estimates, which are based on national screening guideline categorization. Methods From the stage at diagnosis of new breast cancer patients between 2010 and 2014, percentages of invasive cancers, stage 0 + I of total cancers, and stage I of invasive cancers, were calculated. Five-year estimated overall and invasive mortalities were calculated based on stage at diagnosis and SEER survival data. Program categories defined included an Annual Program, based on the ACR (annual screening age 40 and above), a Biennial Program, based on the US Preventative Services Taskforce (biennial screening ages 50 to 74 years), and a Hybrid Program, based on the American Cancer Society (annual screening ages 45 to 54 years, then biennially at ages 55 and above), including respective interval cancers. Results In all, 445 breast cancers met the study inclusion criteria. Comparing program categories, the Annual Program had the lowest percentage of invasive cancers (75.3%), highest percentages of stage 0 + I of total cancers (75.3%) and stage I of invasive cancers (67.1%), and the lowest 5-year estimated overall (10.1%) and stage I to IV (12.0%) mortalities. Estimated overall and stage I to IV mortalities for the Annual Program was 37.3% and 30.6% less, respectively, than the Biennial Program, and 31.8% and 26.8% less, respectively, than the Hybrid Program. Conclusions Based on stage at diagnosis, the greatest mortality reduction is achieved with mammography utilization starting at the age of 40.
Available online 19 May 2018
High-Grade Serous Ovarian Cancer: Use of Machine Learning to Predict Abdominopelvic Recurrence on CT on the Basis of Serial Cancer Antigen 125 Levels
Publication date: Available online 19 May 2018
Source:Journal of the American College of Radiology Author(s): Atul B. Shinagare, Patricia Balthazar, Ivan K. Ip, Ronilda Lacson, Joyce Liu, Nikhil Ramaiya, Ramin Khorasani Purpose The aim of this study was to use machine learning to predict abdominal recurrence on CT on the basis of serial cancer antigen 125 (CA125) levels in patients with advanced high-grade serous ovarian cancer on surveillance. Methods This institutional review board–approved, HIPAA-compliant, retrospective, hypothesis-generating study included all 57 patients (mean age, 61 ± 11.2 years) with advanced high-grade serous ovarian cancer who underwent cytoreductive surgery from January to December 2012, followed by surveillance abdominopelvic CT and corresponding CA125 levels. A blinded radiologist reviewed abdominopelvic CT studies until recurrence was noted. Four measures of CA125 were assessed: actual CA125 levels at the time of CT, absolute change since prior CT, relative change since prior CT, and rate of change since prior CT. Using machine learning, support vector machine models were optimized and evaluated using 10-fold cross-validation to determine the CA125 measure most predictive of abdominal recurrence. The association of the most accurate CA125 measure was further analyzed using Cox proportional-hazards model along with age, tumor size, stage, and degree of cytoreduction. Results Rate of change in CA125 was most predictive of abdominal recurrence in a linear kernel support vector machine model and was significantly higher preceding CT studies showing abdominal recurrence (median 13.2 versus 0.6 units/month; P = .007). On multivariate analysis, a higher rate of CA125 increase was significantly associated with recurrence (hazard ratio, 1.02 per 10 units change; 95% confidence interval, 1.0006-1.04; P = .04). Conclusion A higher rate of CA125 increase is associated with abdominal recurrence. The rate of increase of CA125 may help in the selection of patients who are most likely to benefit from abdominopelvic CT in surveillance of ovarian cancer.
Available online 19 May 2018
Impact of Second-Opinion Interpretation of Breast Imaging Studies in Patients Not Currently Diagnosed With Breast Cancer
Publication date: Available online 19 May 2018
Source:Journal of the American College of Radiology Author(s): Lauren Q. Chang Sen, Ray C. Mayo, Michele D. Lesslie, Wei T. Yang, Jessica W.T. Leung Purpose To study the impact of second-opinion interpretation of breast imaging studies submitted from outside facilities to a tertiary cancer center. Materials and Methods A retrospective database review was conducted of second-opinion interpretations rendered at our institution from January 1, 2010, to June 30, 2014, on studies from patients who did not have a concurrent breast cancer diagnosis. A total of 2,253 patients were included. Results In 800 of 2,253 patients (35.5%), the BI-RADS categories assigned at our institution and at outside facilities were discordant. Of 973 patients assigned BI-RADS category 4 or 5 at outside facilities, 278 (28.6%) were assigned BI-RADS category 1 to 3 (no biopsy necessary) at our institution. Of 923 patients assigned BI-RADS category 1 to 3 at outside facilities, 191 (20.7%) were assigned BI-RADS category 4 or 5 at our institution, and 189 of these had biopsies, which revealed 23 cancers, 15 high-risk lesions, and 151 benign lesions. One high-risk lesion at core biopsy was upgraded to invasive ductal carcinoma and ductal carcinoma in situ (DCIS) on excision, resulting in 24 cancers. Of these, 18 reflected true additional breast cancers detected as a result of second-opinion interpretation: 12 invasive carcinomas and 6 cases of DCIS. These results translate into a 9.4% (18/191) positive predictive value for the number of cancers diagnosed among all biopsies recommended and a 9.5% (18/189) positive predictive value for the number of cancers diagnosed among all biopsies recommended and actually performed. Conclusions These findings demonstrate the positive clinical impact of second-opinion interpretation at a tertiary cancer center of outside-facility breast imaging studies in patients without a breast cancer diagnosis.
Available online 18 May 2018
Assessment of Appropriate Recovery Time After Liver Biopsy
Publication date: Available online 19 May 2018
Source:Journal of the American College of Radiology Author(s): Neema J. Patel, Andrew W. Bowman
Available online 18 May 2018
Geographic Variation in Gender Disparities in the US Radiologist Workforce
Publication date: Available online 18 May 2018
Source:Journal of the American College of Radiology Author(s): Andrew B. Rosenkrantz, Amy L. Kotsenas, Richard Duszak Purpose To assess geographic variation in gender disparities in the US radiologist workforce. Methods Gender, location, and practice affiliation of all radiologists and gender of all nonradiologists were identified for all providers listed in the Medicare Physician Compare database. Variation in female representation among radiologists was summarized at state, county, and individual practice levels, and associations with a variety of county-level population characteristics were explored. Results Nationally, 23.1% (7,501 of 32,429) of all radiologists were women versus 46.6% (481,831 of 1,034,909) of Medicare-participating nonradiologists. At the state level, female representation among radiologists was overall highest in the Northeast and Mid-Atlantic regions (Washington DC, 39.3%; Massachusetts, 34.3%; Maryland, 31.5%) and lowest in the West and Midwest (Wyoming, 9.0%; Montana, 10.7%; Idaho, 11.7%). At the county level, female representation varied from 0.0% to 100.0%, with weak positive correlations with county-level population (r = +0.39), median household income (r = +0.25), college education (r = +0.23), English nonproficiency (r = +0.21), mammography screening rates (r = +0.12), Democratic voting in the 2016 presidential election (r = +0.28), and weak negative correlation with county-level rural population percentage (r = 
Available online 18 May 2018
Patient Friendly Summary of the ACR Appropriateness Criteria: CT for Adult Minor Head Trauma
Publication date: Available online 18 May 2018
Source:Journal of the American College of Radiology Author(s): Celena Romero, Ryan Lee
Available online 18 May 2018
Why Physics in Medicine?
Publication date: Available online 18 May 2018
Source:Journal of the American College of Radiology Author(s): Ehsan Samei, Thomas M. Grist Despite its crucial role in the development of new medical imaging technologies, in clinical practice, physics has primarily been involved in the technical evaluation of technologies. However, this narrow role is no longer adequate. New trajectories in medicine call for a stronger role for physics in the clinic. The movement toward evidence-based, quantitative, and value-based medicine requires physicists to play a more integral role in delivering innovative precision care through the intentional clinical application of physical sciences. There are three aspects of this clinical role: technology assessment based on metrics as they relate to expected clinical performance, optimized use of technologies for patient-centered clinical outcomes, and retrospective analysis of imaging operations to ensure attainment of expectations in terms of quality and variability. These tasks fuel the drive toward high-quality, consistent practice of medical imaging that is patient centered, evidence based, and safe. While this particular article focuses on imaging, this trajectory and paradigm is equally applicable to the multitudes of the applications of physics in medicine.
Available online 18 May 2018
Four Grammies or Three Deanships
Publication date: Available online 18 May 2018
Source:Journal of the American College of Radiology Author(s): Mark E. Schweitzer
Available online 18 May 2018
Qualitative Reporting of Lesion Number: Do Radiologists and Referring Physicians Understand Each Other?
Publication date: Available online 18 May 2018
Source:Journal of the American College of Radiology Author(s): Joseph R. England, Phillip M. Cheng, Miriam Romero
Available online 18 May 2018
Launching a Successful Startup: An Entrepreneur’s Field Guide
Publication date: Available online 18 May 2018
Source:Journal of the American College of Radiology Author(s): Jeremy Snepar, Elliot K. Fishman, Karen M. Horton, Pamela T. Johnson, Steven P. Rowe
Available online 11 May 2018
My American Dream
Publication date: Available online 18 May 2018
Source:Journal of the American College of Radiology Author(s): Driss Raissi
Available online 11 May 2018
Artificial Intelligence and the Practice of Radiology: An Alternative View
Publication date: Available online 11 May 2018
Source:Journal of the American College of Radiology Author(s): Robert Schier
Available online 11 May 2018
Tailoring Radiology Resident Education Using Aggregated Missed-Cases Data
Publication date: Available online 11 May 2018
Source:Journal of the American College of Radiology Author(s): Bryce A. Merritt, Travis S. Henry, Soonmee Cha, Karen G. Ordovas, Kimberly G. Kallianos, Brett M. Elicker, Michael D. Hope, David M. Naeger
Available online 10 May 2018
Patient-Friendly Summary of the ACR Appropriateness Criteria Monitoring Response to Neoadjuvant Systemic Therapy for Breast Cancer
Publication date: Available online 11 May 2018
Source:Journal of the American College of Radiology Author(s): Casey Quinlan, Jennifer W. Uyeda
Available online 10 May 2018
Changing Culture
Publication date: Available online 10 May 2018
Source:Journal of the American College of Radiology Author(s): Frank J. Lexa, David Fessell
Available online 10 May 2018
Radiology Report Readability: An Opportunity to Improve Patient Communication
Publication date: Available online 10 May 2018
Source:Journal of the American College of Radiology Author(s): Anna Trofimova, Brianna L. Vey, Nabile M. Safdar, Richard Duszak, Nadja Kadom
Available online 10 May 2018
Democracy and Burnout: The ACR’s Special Role
Publication date: Available online 10 May 2018
Source:Journal of the American College of Radiology Author(s): Richard B. Gunderman
Available online 10 May 2018
Understanding Why Patients No-Show: Observations of 2.9 Million Outpatient Imaging Visits Over 16 Years
Publication date: Available online 10 May 2018
Source:Journal of the American College of Radiology Author(s): Joshua I. Rosenbaum, Rebecca J. Mieloszyk, Christopher S. Hall, Daniel S. Hippe, Martin L. Gunn, Puneet Bhargava Purpose To understand why patients “no-show” for imaging appointments, and to provide new insights for improving resource utilization. Materials and Methods We conducted a retrospective analysis of nearly 2.9 million outpatient examinations in our radiology information system from 2000 to 2015 at our multihospital academic institution. No-show visits were identified by the “reason code” entry “NOSHOW” in our radiology information system. We restricted data to radiography, CT, mammography, MRI, ultrasound, and nuclear medicine examinations that included all studied variables. These variables included modality, patient age, appointment time, day of week, and scheduling lead time. Multivariate logistic regression was used to identify factors associated with no-show visits. Results Out of 2,893,626 patient visits that met our inclusion criteria, there were 94,096 no-shows during the 16-year period. Rates of no-show visits varied from 3.36% in 2000 to 2.26% in 2015. The effect size for no-shows was strongest for modality and scheduling lead time. Mammography had the highest modality no-show visit rate of 6.99% (odds ratio [OR] 5.38, P < .001) compared with the lowest modality rate of 1.25% in radiography. Scheduling lead time greater than 6 months was associated with more no-show visits than scheduling within 1 week (OR 3.18, P < .001). Patients 60 years and older were less likely to miss imaging appointments than patients under 40 (OR 0.70, P < .001). Mondays and Saturdays had significantly higher rates of no-show than Sundays (OR 1.52 and 1.51, P < .001). Conclusion Modality type and scheduling lead time were the most predictive factors of no-show. This may be used to guide new interventions such as targeted reminders and flexible scheduling.
Available online 8 May 2018
Preoccupied With Work
Publication date: Available online 10 May 2018
Source:Journal of the American College of Radiology Author(s): David Fessell, Frank J. Lexa
Available online 8 May 2018
Modifying Institutional Guidelines Reduces the Likelihood of Oversedation During Interventional Procedures
Publication date: Available online 8 May 2018
Source:Journal of the American College of Radiology Author(s): Jonathan G. Martin, Zachary L. Bercu, Lauren Becker, Morgan Whitmore, Jay Shah, Daryl Goldman, Janice Newsome
Available online 8 May 2018
Diagnosing Happiness: Lessons From Positive Psychology
Publication date: Available online 8 May 2018
Source:Journal of the American College of Radiology Author(s): Sanj Katyal
Available online 7 May 2018
Improving Performance by Using a Radiology Extender
Publication date: Available online 8 May 2018
Source:Journal of the American College of Radiology Author(s): Arijitt Borthakur, J. Bruce Kneeland, Mitchell D. Schnall
Available online 7 May 2018
Pediatric CT Protocols From the American Association of Physicists in Medicine Alliance for Quality CT
Publication date: Available online 7 May 2018
Source:Journal of the American College of Radiology Author(s): Sarah E. McKenney, Cristina T. Dodge
Available online 7 May 2018
The Value of a Disease-Specific Template and an IT-Based Quality Tracking System in Pulmonary Embolism CT Angiography
Publication date: Available online 7 May 2018
Source:Journal of the American College of Radiology Author(s): Jonathan H. Chung, Luis Landeras, Kateland Haas, Peng Liu, Lili Liu, Heber MacMahon
Available online 7 May 2018
The Importance of Spatial Resolution to Medical Imaging
Publication date: Available online 7 May 2018
Source:Journal of the American College of Radiology Author(s): Richard L. Morin, Mahadevappa Mahesh
Available online 7 May 2018
Day of Week, Site of Service, and Patient Complexity Differences in Venous Ultrasound Interpreted by Radiologists Versus Nonradiologists
Publication date: Available online 7 May 2018
Source:Journal of the American College of Radiology Author(s): Anand M. Prabhakar, Ravi V. Gottumukkala, Wenyi Wang, Danny R. Hughes, Richard Duszak Objective Nationally, nonradiologists interpret an increasing proportion of lower extremity venous duplex ultrasound (LEVDU) examinations. We aimed to study day of week, site of service, and patient complexity differences in LEVDU services interpreted by radiologists versus nonradiologists. Materials and Methods Using carrier claims files for a 5% national sample of Medicare beneficiaries from 2012 to 2015, we retrospectively classified all LEVDU examinations by physician specialty (radiologist versus nonradiologist), day of week (weekday versus weekend), site of service, and patient Charlson Comorbidity Index (CCI) scores. Pearson’s
Available online 5 May 2018
Clinical Access and Utilization of Reports and Images in Neuroradiology
Publication date: Available online 7 May 2018
Source:Journal of the American College of Radiology Author(s): Matthew D. Alvin, Mona Shahriari, Evan Honig, Li Liu, David M. Yousem Background The radiology report serves as the primary means of communication between radiologist and clinician. However, the value clinicians place on imaging and reports is variable, with many images of studies or their reports never being viewed. This has implications on the perceived value of the radiologist in the imaging chain. We hypothesized that neurologists, neurosurgeons, and otolaryngologists would view neuroradiology images most frequently and neuroradiology reports least frequently of all medical specialties. Materials and Methods Ordering data were collected on all neuroradiology studies over a 1-month period. Imaging study date and time stamps were obtained for (1) when imaging study orders were placed, (2) when the patient underwent the imaging study, (3) when the imaging studies were viewed, and (4) when the radiology reports were accessed and by whom. Each data point included provider names, locations, departments, and level of training. Results There were 7,438 imaging neuroradiology studies ordered. Overall, 85.7% (6,372) of reports and 53.2% (3,956) of imaging studies were viewed and 13.1% (977) of studies had neither images nor reports viewed. Inpatient neurosurgeons and neurologists viewed both imaging and reports significantly more than primary care specialties (P < .001). In the outpatient setting, this trend stayed true for neurosurgeons though was not true for neurologists (P < .001). Outpatient study imaging and reports were both viewed the least (48.6%), and inpatient study reports were viewed the most (95.2%; P < .001). Conclusion Viewing of imaging and reports varies with neurosurgeons viewing neuroradiology studies more than all other medical specialties. Overall, the reports were viewed significantly more than the images, suggesting that the radiologist and his or her interpretation are more valuable than the study’s images. The radiologists’ value, as measured by reports viewed, was maximal with obstetricians and gynecologists and psychiatry clinicians.
Available online 5 May 2018
Developing a Radiology Global Outreach Elective
Publication date: Available online 5 May 2018
Source:Journal of the American College of Radiology Author(s): Jennifer Chang, Seth Stalcup, Rebecca Stein-Wexler, Leonie Gordon, Stacy E. Smith, J. Pierre Sasson, James C. Anderson, Jennifer E. Gould, Carol P. Geer, Beverly L. Hershey, Kamran Ali, Kristen K. DeStigter, Priscilla J. Slanetz
Available online 5 May 2018
Comparison of MRI Findings After Musculoskeletal Ultrasound: An Opportunity to Reduce Redundant Imaging
Publication date: Available online 5 May 2018
Source:Journal of the American College of Radiology Author(s): Lulu He, Patricia Delzell, Jean Schils
Available online 5 May 2018
The Artificial Intelligence Ecosystem for the Radiological Sciences: Ideas to Clinical Practice
Publication date: Available online 5 May 2018
Source:Journal of the American College of Radiology Author(s): Bibb Allen, Keith Dreyer
Available online 4 May 2018
Lessons of a Life Cut Short
Publication date: Available online 5 May 2018
Source:Journal of the American College of Radiology Author(s): Richard B. Gunderman
Available online 3 May 2018
Management of Incidental Pituitary Findings on CT, MRI, and 18F-Fluorodeoxyglucose PET: A White Paper of the ACR Incidental Findings Committee
Publication date: Available online 4 May 2018
Source:Journal of the American College of Radiology Author(s): Jenny K. Hoang, Andrew R. Hoffman, R. Gilberto Gonz
Available online 3 May 2018
Single-State Tort Reform Analysis: Perspectives From the Volunteer State (Tennessee)
Publication date: Available online 3 May 2018
Source:Journal of the American College of Radiology Author(s): Wes Angel, Margaret Ann Mays, Houston Graves, Ina Radtke
Available online 2 May 2018
Understanding the Rapidly Changing Business Landscape: A Primer for Medical Personnel
Publication date: Available online 3 May 2018
Source:Journal of the American College of Radiology Author(s): Paul Greenberg, Madison B. Johnson, Elliot K. Fishman, Pamela T. Johnson
Available online 2 May 2018
Variation in Downstream Relative Costs Associated With Incidental Ovarian Cysts on Ultrasound
Publication date: Available online 2 May 2018
Source:Journal of the American College of Radiology Author(s): Andrew B. Rosenkrantz, X. Xue, Soterios Gyftopoulos, Danny C. Kim, Gregory N. Nicola Purpose To explore variation in downstream relative costs associated with ovarian cysts incidentally detected on ultrasound. Methods For 200 consecutive incidental ovarian cysts on ultrasound, ultrasound reports were classified in terms of presence of a radiologist recommendation for additional imaging. All downstream events (imaging, office visits, and surgery) associated with the cysts were identified from the electronic health record. Medical costs associated with these downstream events were estimated using national Medicare rates. Average cost per cyst was stratified by various factors; cost ratios were computed among subgroups. Results Average costs per cyst were 1.9 times greater in postmenopausal than premenopausal women. Relative to when follow-up imaging was neither recommended nor obtained, costs were 1.1 times greater when follow-up imaging was recommended but not obtained, 5.1 times greater when follow-up imaging was both recommended and obtained, and 8.1 times greater when follow-up imaging was obtained despite not being recommended. Costs were 2.5 times greater when the radiologist underrecommended follow-up compared with Society of Radiologists in Ultrasound (SRU) guidelines for management of ovarian cysts, 3.0 times greater when the ordering physician overmanaged compared with the radiologist’s recommendation, as well as 1.7 times and 3.8 times greater when the ordering physician undermanaged and overmanaged compared with SRU guidelines, respectively. Four ovarian neoplasms, although no ovarian malignancy, were diagnosed in the cohort. Conclusion Follow-up costs for incidental ovarian cysts are highly variable based on a range of factors. Radiologist recommendations may contribute to lower costs among patients receiving follow-up imaging. Such recommendations should reflect best practices and support the follow-up that will be of likely greatest value for patient care.
Available online 2 May 2018
Interactive Multimedia Reporting: Key Features and Experience in Clinical Practice
Publication date: Available online 2 May 2018
Source:Journal of the American College of Radiology Author(s): Steven D. Beesley, Cree M. Gaskin
Available online 2 May 2018
Inclusion of Pediatric-Specific Indications and Procedures in the New ACR MRI Accreditation Program
Publication date: Available online 2 May 2018
Source:Journal of the American College of Radiology Author(s): Suraj D. Serai, Cynthia K. Rigsby, Herman J. Kan, Ashok Panigrahy, Marta Hernanz-Schulman, Sudha A. Anupindi MRI equipment with its complex instrumentation and adaptable software applications is vulnerable to technical and image quality problems, and maintaining quality assurance is essential. Accreditation of MRI centers by the ACR has become a routine practice for radiology departments and imaging centers across the country. In its prior format, the ACR MRI Accreditation Program had examination anatomic modules designed primarily to measure quality and validate MR performance primarily in adult imaging practices. In an effort to more closely meet the specific imaging requirements of pediatric patients, an ad hoc MR accreditation committee was created under the ACR Commission on Pediatric Imaging. The committee, consisting of ACR members from five children’s hospitals, was tasked with creating suggested revisions to the anatomic modules and helping develop pediatric-specific studies that could be adopted into the ACR MRI Accreditation Program. Updated ACR MRI accreditation anatomic modules incorporating the ad hoc committee’s recommendations were released by ACR in May 2017. This article highlights the recommendations made by the ad hoc committee. The revised modules should allow pediatric imaging centers to achieve ACR MRI accreditation for all anatomic modules and will underscore best imaging practices for patients of all ages.
Available online 2 May 2018
Comprehensive Health Care Economics Curriculum and Training in Radiology Residency
Publication date: Available online 2 May 2018
Source:Journal of the American College of Radiology Author(s): Mark Keiper, Timothy Donovan, Matthew DeVries Purpose To investigate the ability to successfully develop and institute a comprehensive health care economics skills curriculum in radiology residency training utilizing didactic lectures, case scenario exercises, and residency miniretreats. Methods A comprehensive health care economics skills curriculum was developed to significantly expand upon the basic ACGME radiology residency milestone System-Based Practice, SBP2: Health Care Economics requirements and include additional education in business and contract negotiation, radiology sales and marketing, and governmental and private payers’ influence in the practice of radiology. Results A health care economics curriculum for radiology residents incorporating three phases of education was developed and implemented. Phase 1 of the curriculum constituted basic education through didactic lectures covering System-Based Practice, SBP2: Health Care Economics requirements. Phase 2 constituted further, more advanced didactic lectures on radiology sales and marketing techniques as well as government and private insurers’ role in the business of radiology. Phase 3 applied knowledge attained from the initial two phases to real-life case scenario exercises and radiology department business miniretreats with the remainder of the radiology department. Conclusion A health care economics skills curriculum in radiology residency is attainable and essential in the education of future radiology residents in the ever-changing climate of health care economics. Institution of more comprehensive programs will likely maximize the long-term success of radiology as a specialty by identifying and educating future leaders in the field of radiology.
Available online 2 May 2018
Science to Practice: IT Solutions to Drive Standardized Report Recommendations for Abdominal Aortic Aneurysm Surveillance
Publication date: Available online 2 May 2018
Source:Journal of the American College of Radiology Author(s): Danny C. Kim, Edward H Herskovits, Pamela T. Johnson Inadequate imaging surveillance has been identified as the most significant contributor to abdominal aortic aneurysm (AAA) rupture. Radiologists can contribute value to patient care and reduce morbidity and mortality related to AAA by incorporating evidence-based management recommendations from the ACR and Society of Vascular Surgery into their report impression. The challenges lie in achieving 100% radiologist compliance to incorporate the recommendations and ensuring that the patient is notified by their provider, the follow-up examination is scheduled, and the patient returns for an imaging test that may be scheduled 3 to 5 years in the future. To address these barriers, radiology quality and informatics leads have harnessed IT solutions to facilitate integration of content, communication of results, and patient follow-up.
May 2018
Geographic Patterns of Radiology Referrals in the United States: A Descriptive Network Analysis
Publication date: Available online 2 May 2018
Source:Journal of the American College of Radiology Author(s): Geraldine J. Liao, Joshua M. Liao, Tessa S. Cook Purpose To provide a nationwide description of radiology referral patterns for Medicare beneficiaries and network-based measures that can describe and monitor shifts in referral patterns. Methods We linked publicly available Medicare data with the National Plan and Provider Enumeration System data set to analyze 3,925,366 encounters representing referrals from nonradiology referrers to diagnostic radiology providers in 2015. We assessed per-state referral volume as well as in-state and in-region referrals and the correlation between state referral volume and in-state referrals. Additionally, we applied the conceptual framework of networks to create two measures to evaluate referrer–radiologist connections within each state: number of referrer relationships and referral density index (RDI). Results In 2015, there was considerable variation in in-state referrals across states, and the correlation between state referral volume and in-state referrals was low (0.18). Across census regions, in-region referrals were high (84.3% in the South to 89.2% in the Midwest). Across states, the mean number of referrer relationships ranged from 7.0 in Utah to 25.0 in California, and the number of referrer relationships varied significantly within states. Radiology provider RDI also varied both within and across states, with mean radiology provider RDI spanning from 0.05 in Kansas to 0.25 in Hawaii. Conclusions In a nationwide description of geographic patterns in radiology referrals among Medicare beneficiaries, we demonstrate wide variation in radiology referral patterns and utilized network methods to develop two measures that can be used in the future to monitor shifts in referral patterns.
May 2018
Cover
Publication date: May 2018
Source:Journal of the American College of Radiology, Volume 15, Issue 5, Supplement

May 2018
Communicating Radiology’s Bright Future
Publication date: May 2018
Source:Journal of the American College of Radiology, Volume 15, Issue 5 Author(s): Geraldine B. McGinty
May 2018
Table of Contents
Publication date: May 2018
Source:Journal of the American College of Radiology, Volume 15, Issue 5, Supplement

May 2018
The Mind Tends to Wander
Publication date: May 2018
Source:Journal of the American College of Radiology, Volume 15, Issue 5 Author(s): Bruce J. Hillman
May 2018
It’s Never Over
Publication date: May 2018
Source:Journal of the American College of Radiology, Volume 15, Issue 5 Author(s): Julianna M. Czum

The Role of the ACR Appropriateness Criteria in the Medical Literature
Publication date: May 2018
Source:Journal of the American College of Radiology, Volume 15, Issue 5, Supplement Author(s): Frank J. Rybicki
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Were treated to the site administrator, a cup of coffee *https://paypal.me/peterlife
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