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Canadian Association of Radiologists Journal
Journal Prestige (SJR): 0.463  Citation Impact (citeScore): 1 Number of Followers: 1  Subscription journalISSN (Print) 0846-5371 - ISSN (Online) 1488-2361 Published by Sage Publications  [1176 journals]
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- Canadian Association of Radiologists Breast Disease Imaging Referral
Guideline-
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Authors: Candyce Hamel, Barb Avard, Carolyn Flegg, Vivianne Freitas, Connie Hapgood, Supriya Kulkarni, Pam Lenkov, Matthew Seidler
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
The Canadian Association of Radiologists (CAR) Breast Disease Expert Panel consists of breast imaging radiologists, a high-risk breast clinician, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 20 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 30 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for guidelines framework were used to develop 69 recommendation statements across the 20 scenarios. This guideline presents the methods of development and the recommendations for referring asymptomatic individuals, symptomatic patients, and other scenarios requiring imaging of the breast.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-09-19T07:21:57Z
DOI: 10.1177/08465371231192391
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- Photon-Counting Computed Tomography: A Potentially Groundbreaking Imaging
Technology With Challenges to be Faced-
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Authors: Juan Martín Leguízamo-Isaza, Laura Andrea Campaña Perilla, Juan Francisco Ayala Valderrama, Bibiana Andrea Pinzón Valderrama
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-09-13T04:13:47Z
DOI: 10.1177/08465371231200837
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- Reply to: “Can ChatGPT Truly Overcome Other LLMs'”
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Authors: Nikhil S. Patil, Ryan S. Huang, Christian B. van der Pol, Natasha Larocque
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-09-12T04:52:24Z
DOI: 10.1177/08465371231201379
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- CARJ Editor’s Award 2023
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Authors: Birgit B. Ertl-Wagner, Cortney R. Green, Michael N. Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-09-09T01:52:01Z
DOI: 10.1177/08465371231201755
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- Canadian Association of Radiologists Trauma Diagnostic Imaging Referral
Guideline-
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Authors: Candyce Hamel, Nishard Abdeen, Barb Avard, Samuel Campbell, Noel Corser, Noah Ditkofsky, Ferco Berger, Nicolas Murray
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
The Canadian Association of Radiologists (CAR) Trauma Expert Panel consists of adult and pediatric emergency and trauma radiologists, emergency physicians, a family physician, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 21 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for 1 or more of these clinical/diagnostic scenarios. Recommendations from 49 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for guidelines framework were used to develop 50 recommendation statements across the 21 scenarios related to the evaluation of traumatic injuries. This guideline presents the methods of development and the recommendations for head, face, neck, spine, hip/pelvis, arms, legs, superficial soft tissue injury foreign body, chest, abdomen, and non-accidental trauma.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-09-08T03:10:51Z
DOI: 10.1177/08465371231182972
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- Can ChatGPT Truly Overcome Other Large Langauge Models'
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Authors: Partha Pratim Ray
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-09-06T10:38:09Z
DOI: 10.1177/08465371231199444
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- The Landscape of Rural and Remote Radiology in Canada: Opportunities and
Challenges-
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Authors: Malcolm Davidson, Ania Kielar, R.Petter Tonseth, Karen Seland, Sarah Harvie, Kate Hanneman
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Diagnostic and interventional radiology play a crucial role in healthcare, facilitating diagnosis of disease, treatment planning, interventional therapies, and assessment for response to treatment. However, many rural and remote regions are disproportionately limited in accessing high-quality radiological services. Challenges include limited imaging infrastructure in these communities, geographic isolation, and workforce shortages impacting provision of interventional image-guided procedures and subspecialty imaging in particular. However, a career in rural or remote radiology also presents unique opportunities including a deep sense of community, broad scope of practice, and immense benefit to patient care. This review aims to explore the landscape of rural and remote radiology with a focus on Canada, including opportunities, challenges, and potential strategies. Some of the challenges are shared by both rural and remote communities while others are distinct. Factors that have contributed to challenges in recruitment and retention of rural and remote radiologists include workload burden, inadequate or suboptimal imaging and interventional equipment, and limited exposure during training. Additionally, strategies to improve the provision of radiology services in rural and remote communities are highlighted, addressing both the workforce shortage and the lack of essential equipment and other resources.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-28T12:07:06Z
DOI: 10.1177/08465371231197953
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- Canadian Association of Radiologists Musculoskeletal System Diagnostic
Imaging Referral Guideline-
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Authors: Candyce Hamel, Barb Avard, Natalia Gorelik, Martin Heroux, David Mai, Adnan Sheikh, Anthony Vo, Mary-Lynn Watson, Kawan Rakhra
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
The Canadian Association of Radiologists (CAR) Musculoskeletal System Expert Panel consists of musculoskeletal radiologists, a family physician, a sports and exercise medicine physician, emergency medicine physicians, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 25 musculoskeletal clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for 1 or more of these clinical/diagnostic scenarios. Recommendations from 41 guidelines (50 publications) and contextualization criteria in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for guidelines framework were used to develop 124 recommendation statements across the 25 scenarios related to the evaluation of the musculoskeletal system. This guideline presents the methods of development and the recommendations for imaging in the context of musculoskeletal pain, infection, tumors, arthropathies, metabolic bone disease, stress injuries, orthopedic hardware, avascular necrosis/bone infarction, and complex regional pain syndrome.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-28T03:59:46Z
DOI: 10.1177/08465371231190807
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- Canadian Association of Radiologists Obstetrics and Gynecology Diagnostic
Imaging Referral Guideline-
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Authors: Candyce Hamel, Baharak Amir, Barb Avard, Karen Fung-Kee-Fung, Beth Furey, Juliette Garel, Hournaz Ghandehari
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
The Canadian Association of Radiologists (CAR) Obstetrics and Gynecology Expert Panel consists of radiologists specializing in obstetrics and gynecology, obstetrics and gynecology physicians, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 12 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 46 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for guidelines framework were used to develop 68 recommendation statements across the 12 scenarios related to the evaluation of obstetrics and gynecology clinical and diagnostic scenarios. This guideline presents the methods of development and the imaging recommendations for a variety of obstetrical and gynecological conditions including pregnancy assessment, recurrent first trimester pregnancy loss, post-partum indications, disorders of menstruation, localization of intra-uterine contraceptive device, infertility assessment, assessment of adnexal mass, pelvic pain of presumed gynecological origin, and pelvic floor evaluation.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-25T02:46:08Z
DOI: 10.1177/08465371231185292
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- Evaluation of the Association Between Sociodemographic Status and Breast
Screening Volumes During the COVID-19 Pandemic in a Provincial,
Population-Based Organized Breast Screening Program-
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Authors: Helena Bentley, Nivedha Raveinthiranathan, Colin Mar, Terry Tang, Dean A. Regier, Kim Chi, Jonathan Simkin, Zina Kellow, Charlotte J. Yong-Hing, Ryan R. Woods
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
ObjectivesWe sought to evaluate the association between patient sociodemographic status and breast screening volumes (BSVs) during the COVID-19 pandemic in a large, population-based breast screening program that serves a provincial population of over 5 million. Methods: All patients who completed breast screening between April 1st, 2017 and March 31st, 2021 were eligible to participate. An average of 3 annual periods between April 1st, 2017 and March 31st, 2020 were defined as the pre-COVID period while the period between April 1st, 2020 and March 31st, 2021 was defined as the COVID-impacted period. The Postal CodeOM Conversion File Plus was applied to map patient residential postal codes to 2016 census standard geographical areas, which provided information on community size, income quintile and dissemination areas. Dissemination areas were subsequently linked to the Canadian Index of Multiple Deprivation (CIMD).ResultsOverall BSV was reduced by 23.0% during the COVID-impacted period as compared to the pre-COVID period. Percent reductions in BSVs were greatest among younger patients aged 40 to 49 years (31.3%) and patients residing in communities with a population of less than 10,000 (27.0%). Percent reduction in BSV was greatest among patients in the lowest income quintile (28.1%). Percent reductions in BSVs were greatest for patients in the most deprived quintiles across all 4 dimensions of the CIMD.ConclusionDisproportionate reductions in BSVs were observed during the COVID-19 pandemic among younger patients, patients residing in rural communities, patients in lower income quintiles, and patients in the most deprived quintiles across all 4 dimensions of the CIMD.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-24T10:58:57Z
DOI: 10.1177/08465371231192277
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- Collaborative Strategies for Advancing Medical Education in Interventional
Radiology-
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Authors: David Li, Andrew D. Brown
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-23T05:57:06Z
DOI: 10.1177/08465371231198237
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- Towards Structured Reporting: Enhancing Patient-Centered Care in Radiology
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Authors: Joel L. Gamble, Alison Harris, Gilles Soulez
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-18T11:39:19Z
DOI: 10.1177/08465371231196494
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- Breast Magnetic Resonance Imaging for Preoperative Evaluation of Breast
Cancer: A Systematic Review and Meta-Analysis-
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Authors: Andrea Eisen, Glenn G. Fletcher, Samantha Fienberg, Ralph George, Claire Holloway, Supriya Kulkarni, Jean M. Seely, Derek Muradali
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: Preoperative breast magnetic resonance imaging (MRI) is known to detect additional cancers that are occult on mammography and ultrasound. There is debate as to whether these additional lesions affect clinical outcomes. The objective of this systematic review was to summarize the evidence on whether additional information on disease extent obtained with preoperative breast MRI in patients with newly diagnosed breast cancer affects surgical management, rates of recurrence, survival, re-excision, and early detection of bilateral cancer. Methods: Embase, MEDLINE, and Cochrane Central Register of Controlled Trials were searched until January 2021 (partial update July 2022) for studies comparing outcomes with versus without pre-operative MRI. Included were both randomized controlled trials and other comparative studies provided MRI and control groups had equivalent disease and patient characteristics or methods such as multivariable analysis or propensity score matching were used to control potential confounders. Results: The search resulted in 26,399 citations, of which 8 randomized control trials, 1 prospective cohort study, and 42 retrospective studies met the inclusion criteria. Use of MRI resulted in decreased rates of reoperations (OR = 0.73, 95% CI = 0.63 to 0.85), re-excisions (OR = 0.63, 95% CI = 0.45 to 0.89), and recurrence (HR = 0.77, 95% CI = 0.65 to 0.90). Increased detection of synchronous contralateral breast cancers led to a reduction in metachronous contralateral breast cancer (HR = 0.71, 95% CI = 0.59 to 0.85). Hazard ratios for recurrence-free and overall survival were 0.77 (95% CI = 0.53 to 1.12) and 0.89 (95% CI = 0.74 to 1.07). Conclusion: This systematic review indicates substantial benefits of pre-operative breast MRI in decreasing reoperations and recurrence.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-18T07:59:22Z
DOI: 10.1177/08465371231184769
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- Comparative Performance of ChatGPT and Bard in a Text-Based Radiology
Knowledge Assessment-
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Authors: Nikhil S. Patil, Ryan S. Huang, Christian B. van der Pol, Natasha Larocque
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
PurposeBard by Google, a direct competitor to ChatGPT, was recently released. Understanding the relative performance of these different chatbots can provide important insight into their strengths and weaknesses as well as which roles they are most suited to fill. In this project, we aimed to compare the most recent version of ChatGPT, ChatGPT-4, and Bard by Google, in their ability to accurately respond to radiology board examination practice questions.MethodsText-based questions were collected from the 2017-2021 American College of Radiology’s Diagnostic Radiology In-Training (DXIT) examinations. ChatGPT-4 and Bard were queried, and their comparative accuracies, response lengths, and response times were documented. Subspecialty-specific performance was analyzed as well.Results318 questions were included in our analysis. ChatGPT answered significantly more accurately than Bard (87.11% vs 70.44%, P < .0001). ChatGPT’s response length was significantly shorter than Bard’s (935.28 ± 440.88 characters vs 1437.52 ± 415.91 characters, P < .0001). ChatGPT’s response time was significantly longer than Bard’s (26.79 ± 3.27 seconds vs 7.55 ± 1.88 seconds, P < .0001). ChatGPT performed superiorly to Bard in neuroradiology, (100.00% vs 86.21%, P = .03), general & physics (85.39% vs 68.54%, P < .001), nuclear medicine (80.00% vs 56.67%, P < .01), pediatric radiology (93.75% vs 68.75%, P = .03), and ultrasound (100.00% vs 63.64%, P < .001). In the remaining subspecialties, there were no significant differences between ChatGPT and Bard’s performance.ConclusionChatGPT displayed superior radiology knowledge compared to Bard. While both chatbots display reasonable radiology knowledge, they should be used with conscious knowledge of their limitations and fallibility. Both chatbots provided incorrect or illogical answer explanations and did not always address the educational content of the question.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-14T04:22:02Z
DOI: 10.1177/08465371231193716
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- Comparison Between Radial and Femoral Artery Access for Transarterial
Chemoembolisation in Patients With Hepatocellular Carcinoma-
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Authors: Mohamed Hedjoudje, Maxime Barat, Anthony Dohan, Alexandre Lucas, Raphael Dautry, Romain Coriat, Ugo Marchese, Stanislas Pol, Lucia Parlati, Philippe Soyer
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
PurposeThe purpose of this study was to compare the technical success rate, the selectivity of transarterial chemoembolisation (TACE), the complication rate, the radiation dose given to the patients and the hospitalization stay between TACE performed using femoral artery approach (FAA) and TACE performed using radial artery approach (RAA) in patients with hepatocellular carcinoma (HCC).MethodsBetween June 2020 and April 2022, 49 patients with HCC who underwent 116 TACEs (75 using FAA and 41 using RAA) were included. Differences in technical success rate, selectivity of micro-catheterization, radiation dose given to the patients, fluoroscopy time, hospitalization stay duration, and complication rate were compared between FAA and RAA using Fisher exact or Student t tests.ResultsNo differences in technical success rates were found between RAA (93%; 39/41 TACEs) and FAA (100%; 75/75 TACEs) (P = .12). There were no differences between the two groups in terms of selectivity of catheterization, radiation dose, fluoroscopy time and hospitalization stay duration. Five patients had Grade 2 complications (hematoma) after FAA vs. one patient with one Grade 1 complication (radial artery occlusion) after RAA (5/75 [7%] vs. 1/41 [2%], respectively; P = .42). No major arterial access site complications occurred with FAA or RAA.ConclusionsThis study confirms that RAA is a safe approach that does not compromise the technical efficacy and the selectivity of TACE compared to FAA in patients with HCC.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-11T04:45:00Z
DOI: 10.1177/08465371231186524
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- Editor’s Corner: February 2024
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Authors: Abdullah Alabousi, Mostafa Alabousi, Michael Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-10T01:27:32Z
DOI: 10.1177/08465371231193733
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- Peritumoral Radiomics for Identification of Telomerase Reverse
Transcriptase Promoter Mutation in Patients With Glioblastoma Based on
Preoperative MRI-
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Authors: Hongbo Zhang, Beibei Zhou, Hanwen Zhang, Yuze Zhang, Yi Lei, Biao Huang
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: To evaluate the value of intra- and peritumoral deep learning (DL) features based on multi-parametric magnetic resonance imaging (MRI) for identifying telomerase reverse transcriptase (TERT) promoter mutation in glioblastoma (GBM). Methods: In this study, we included 229 patients with GBM who underwent preoperative MRI in two hospitals between November 2016 and September 2022. We used four 2D Convolutional Neural Networks (GoogLeNet, DenseNet121, VGG16, and MobileNetV3-Large) to extract intra- and peritumoral DL features. The Mann–Whitney U test, Pearson correlation analysis, least absolute shrinkage and selection operator, and logistic regression analysis were used for feature selection and construction of DL radiomics (DLR) signatures in different regions. These multi-parametric and multi-region signatures were combined to identify TERT promoter mutation. The area under the receiver operating characteristic curve (AUC) was used to evaluate the effects of the signatures. Results: The signatures based on the DL features from the peritumoral regions with expansion distances of 2 mm, 8 mm, and 10 mm using the GoogLeNet architecture correlated with the optimal AUC values (test set: .823, .753, and .768) in the T2-weighted, T1-weighted contrast-enhanced, and T1-weighted images. Using the stacking fusion method, DLR with multi-parameter and multi-region fusion achieved the best discrimination with AUC values of .948 and .902 in the training and test sets, respectively. Conclusions: The radiomics model based on the fusion of multi-parameter MRI intra- and peritumoral DLR signatures may help to identify TERT promoter mutation in patients with GBM.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-08T02:10:55Z
DOI: 10.1177/08465371231183309
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- Plugging the Leak: Addressing the Mid-career Pipeline Challenge in
Radiology-
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Authors: Charlotte J. Yong-Hing, Daria Manos, Michael N. Patlas, Lucy M. Spalluto
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-07T12:48:55Z
DOI: 10.1177/08465371231189202
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- Medico-Legal Cases in Breast Imaging in Canada: A Trend Analysis
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Authors: Jean M. Seely, Laura Payant, Cathy Zhang, Rana Aslanova, Sharon Chothia, Anna MacIntyre, Isabelle Trop, Qian Yang, Gary Garber, Michael Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: Breast imaging accounts for a large proportion of medico-legal cases involving radiologists in several countries and may be a disincentive to breast imaging. As this has not been well studied in Canada, we evaluated the key medico-legal issues of breast imaging in Canada and their implications for health care providers and patient safety. Methods: In collaboration with Canadian Medical Protective Association (CMPA), we obtained information from the medico-legal repository, including civil-legal, medical regulatory authority (College) and hospital complaints occurring between 2002-2021. Canadian Classification of Health Interventions (CCI) codes were used for breast imaging and biopsy. Trend analysis was done comparing cases involving breast imaging/biopsy to all cases where a radiologist was named. Results: Radiologists were named in 3108 medico-legal cases, 188 (6%, 188/3108) of which were CCI coded for breast imaging or biopsy. Factors related to radiologists were most frequent (64%, 120/188), followed by team (23.4%, 44/188) and system (6.9%, 13/188). Equal representation of male and female radiologists was found (IRR = 1.22; 95% CI: .89, 1.56). In a 10-year test window from 2006 - 2015 we identified an increasing trend for all cases involving radiologists (P = 0,0128) but a decreasing trend for cases coded with breast imaging or biopsy (P = 0,0099). Conclusions: A significant decrease in cases involving breast imaging were found from 2006-2015, accounting for 6% of the medico-legal cases. The lower risk of breast imaging medico-legal issues may encourage more radiologists in breast imaging.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-05T08:28:02Z
DOI: 10.1177/08465371231193366
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- Use of Opportunistic CT Biomarkers: Population Health Opportunities in
Radiology-
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Authors: Nikhil S. Patil, Ania Z. Kielar
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-03T08:00:00Z
DOI: 10.1177/08465371231186356
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- CT-Fluoroscopy Guided Percutaneous Biopsy of Cardio-Pericardial Masses
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Authors: Patrik Rogalla, Ciara O’Brien, Mini Pakkal, Sonja Kandel, Nikta Sarie, Robert James Cusimano, Marina Pourafkari
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-02T12:57:04Z
DOI: 10.1177/08465371231187873
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- Invited Commentary: Agreement for Blunt Splenic Injuries Has Room for
Improvement-
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Authors: M. Hunter Lanier, Vincent M. Mellnick
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-02T03:59:06Z
DOI: 10.1177/08465371231189681
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- Imaging of Gastrointestinal Stromal Tumors: The Next Wave of Radiology
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Authors: Elliot K. Fishman, Linda C. Chu
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-08-02T03:54:27Z
DOI: 10.1177/08465371231189709
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- Bridging the Divide: Strengthening Medical Education on Interventional
Radiology-
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Authors: Rooshi Parikh, Shivam Khatri
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-07-20T01:17:37Z
DOI: 10.1177/08465371231191450
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- Controversial Perspectives on the Use of Twitter in Radiology Education
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Authors: Arosh S. Perera Molligoda Arachchige
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-07-14T01:47:29Z
DOI: 10.1177/08465371231190019
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- Machine Learning Classification of Body Part, Imaging Axis, and
Intravenous Contrast Enhancement on CT Imaging-
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Authors: Wuqi Li, Hui Ming Lin, Amy Lin, Marc Napoleone, Robert Moreland, Alexis Murari, Maxim Stepanov, Eric Ivanov, Abhinav Sanjeeva Prasad, George Shih, Zixuan Hu, Suvd Zulbayar, Ervin Sejdić, Errol Colak
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: The development and evaluation of machine learning models that automatically identify the body part(s) imaged, axis of imaging, and the presence of intravenous contrast material of a CT series of images. Methods: This retrospective study included 6955 series from 1198 studies (501 female, 697 males, mean age 56.5 years) obtained between January 2010 and September 2021. Each series was annotated by a trained board-certified radiologist with labels consisting of 16 body parts, 3 imaging axes, and whether an intravenous contrast agent was used. The studies were randomly assigned to the training, validation and testing sets with a proportion of 70%, 20% and 10%, respectively, to develop a 3D deep neural network for each classification task. External validation was conducted with a total of 35,272 series from 7 publicly available datasets. The classification accuracy for each series was independently assessed for each task to evaluate model performance. Results: The accuracies for identifying the body parts, imaging axes, and the presence of intravenous contrast were 96.0% (95% CI: 94.6%, 97.2%), 99.2% (95% CI: 98.5%, 99.7%), and 97.5% (95% CI: 96.4%, 98.5%) respectively. The generalizability of the models was demonstrated through external validation with accuracies of 89.7 - 97.8%, 98.6 - 100%, and 87.8 - 98.6% for the same tasks. Conclusions: The developed models demonstrated high performance on both internal and external testing in identifying key aspects of a CT series.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-07-13T09:09:13Z
DOI: 10.1177/08465371231180844
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- Canadian Association of Radiologists Practice Guidelines for Computed
Tomography Colonography-
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Authors: Tanya Chawla, Casey Hurrell, Valerie Keough, Chris M. Lindquist, Mohammed F. Mohammed, Caroline Samson, Gavin Sugrue, Cynthia Walsh
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Colon cancer is the third most common malignancy in Canada. Computed tomography colonography (CTC) provides a creditable and validated option for colon screening and assessment of known pathology in patients for whom conventional colonoscopy is contraindicated or where patients self-select to use imaging as their primary modality for initial colonic assessment. This updated guideline aims to provide a toolkit for both experienced imagers (and technologists) and for those considering launching this examination in their practice. There is guidance for reporting, optimal exam preparation, tips for problem solving to attain high quality examinations in challenging scenarios as well as suggestions for ongoing maintenance of competence. We also provide insight into the role of artificial intelligence and the utility of CTC in tumour staging of colorectal cancer. The appendices provide more detailed guidance into bowel preparation and reporting templates as well as useful information on polyp stratification and management strategies. Reading this guideline should equip the reader with the knowledge base to perform colonography but also provide an unbiased overview of its role in colon screening compared with other screening options.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-07-06T09:06:24Z
DOI: 10.1177/08465371231182975
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- Establishing and Leading a 3D Postprocessing Radiology Lab: A Managerial
and Leadership Perspective-
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Authors: Farzaneh Shobeirian, Nikan Zerafatjou, Kyle Eckhardt, Savvas Nicolaou
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
The rapid acquisition of larg volumes of thin-section CT images has created a considerable need and interest for 3D postprocessing during the interpretation of medical imaging. As a result of the increasing number of postprocessing applications, requiring diagnostic radiologists to perform postprocessing is no longer realistic. This article is a comprehensive review of medical resources regarding establishing a postprocessing radiology laboratory. Besides, leadership and managerial aspects have been covered through a professional business lens. In large-volume settings, a dedicated 3D postprocessing lab ensures the quality, reproducibility, and efficiency of images. Adequate staffing is necessary to fulfill the postprocessing requirements. Educational and experience requirements for 3D technologists may vary among different running laboratories. To evaluate the establishment and running of a 3D lab, it is beneficial to implement diagnostic radiology cost-effectiveness tools. Although establishing a 3D lab has many benefits, certain challenges should be considered. Outsourcing or offshoring may serve as alternatives for establishing a postprocessing laboratory. Building and operating a 3D lab is a significant change in healthcare facilities, and it is crucial for organizations to be aware of the strong resistance toward alternatives the status quo, known as the status quo trap. The change process has essential steps, and skipping the steps creates an illusion of speed but never produces satisfactory results. The organization should ensure the engagement of all interested parties in the whole process. Moreover, a clear vision and proper communication of the vision are vital, and it is crucial to value small wins and ensure expectation clarity in leading the lab during the process.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-07-05T06:02:11Z
DOI: 10.1177/08465371231184499
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- Interrater Agreement of CT Grading of Blunt Splenic Injuries: Does the
AAST Grading Need to Be Reimagined'-
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Authors: R. Chris Adams-McGavin, Monica Tafur, Paraskevi A. Vlachou, Matthew Wu, Michael Brassil, Priscila Crivellaro, Hui-Ming Lin, David Gomez, Errol Colak
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Introduction: The Revised Organ Injury Scale (OIS) of the American Association for Surgery of Trauma (AAST) is the most widely accepted classification of splenic trauma. The objective of this study was to evaluate inter-rater agreement for CT grading of blunt splenic injuries. Methods: CT scans in adult patients with splenic injuries at a level 1 trauma centre were independently graded by 5 fellowship trained abdominal radiologists using the AAST OIS for splenic injuries – 2018 revision. The inter-rater agreement for AAST CT injury score, as well as low-grade (IIII) versus high-grade (IV-V) splenic injury was assessed. Disagreement in two key clinical scenarios (no injury versus injury, and high versus low grade) were qualitatively reviewed to identify possible sources of disagreement. Results: A total of 610 examinations were included. The inter-rater absolute agreement was low (Fleiss kappa statistic 0.38, P < 0.001), but improved when comparing agreement between low and high grade injuries (Fleiss kappa statistic of 0.77, P < .001). There were 34 cases (5.6%) of minimum two-rater disagreement about no injury vs injury (AAST grade ≥ I). There were 46 cases (7.5%) of minimum two-rater disagreement of low grade (AAST grade I-III) versus high grade (AAST grade IV-V) injuries. Likely sources of disagreement were interpretation of clefts versus lacerations, peri-splenic fluid versus subcapsular hematoma, application of adding multiple low grade injuries to higher grade injuries, and identification of subtle vascular injuries. Conclusion: There is low absolute agreement in grading of splenic injuries using the existing AAST OIS for splenic injuries.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-07-05T03:01:19Z
DOI: 10.1177/08465371231184425
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- MRI-Based End-To-End Pediatric Low-Grade Glioma Segmentation and
Classification-
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Authors: Partoo Vafaeikia, Matthias W. Wagner, Cynthia Hawkins, Uri Tabori, Birgit B. Ertl-Wagner, Farzad Khalvati
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: MRI-based radiomics models can predict genetic markers in pediatric low-grade glioma (pLGG). These models usually require tumour segmentation, which is tedious and time consuming if done manually. We propose a deep learning (DL) model to automate tumour segmentation and build an end-to-end radiomics-based pipeline for pLGG classification. Methods: The proposed architecture is a 2-step U-Net based DL network. The first U-Net is trained on downsampled images to locate the tumour. The second U-Net is trained using image patches centred around the located tumour to produce more refined segmentations. The segmented tumour is then fed into a radiomics-based model to predict the genetic marker of the tumour. Results: Our segmentation model achieved a correlation value of over 80% for all volume-related radiomic features and an average Dice score of .795 in test cases. Feeding the auto-segmentation results into a radiomics model resulted in a mean area under the ROC curve (AUC) of .843, with 95% confidence interval (CI) [.78-.906] and .730, with 95% CI [.671-.789] on the test set for 2-class (BRAF V600E mutation BRAF fusion) and 3-class (BRAF V600E mutation BRAF fusion and Other) classification, respectively. This result was comparable to the AUC of .874, 95% CI [.829-.919] and .758, 95% CI [.724-.792] for the radiomics model trained and tested on the manual segmentations in 2-class and 3-class classification scenarios, respectively. Conclusion: The proposed end-to-end pipeline for pLGG segmentation and classification produced results comparable to manual segmentation when it was used for a radiomics-based genetic marker prediction model.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-07-04T02:21:12Z
DOI: 10.1177/08465371231184780
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- CT and MRI of Gastrointestinal Stromal Tumors: New Trends and Perspectives
-
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Authors: Maxime Barat, Anna Pellat, Anthony Dohan, Christine Hoeffel, Romain Coriat, Philippe Soyer
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Gastrointestinal stromal tumors (GISTs) are defined as mesenchymal tumors of the gastrointestinal tract that express positivity for CD117, which is a c-KIT proto-oncogene antigen. Expression of the c-KIT protein, a tyrosine kinase growth factor receptor, allows the distinction between GISTs and other mesenchymal tumors such as leiomyoma, leiomyosarcoma, schwannoma and neurofibroma. GISTs can develop anywhere in the gastrointestinal tract, as well as in the mesentery and omentum. Over the years, the management of GISTs has improved due to a better knowledge of their behaviors and risk or recurrence, the identification of specific mutations and the use of targeted therapies. This has resulted in a better prognosis for patients with GISTs. In parallel, imaging of GISTs has been revolutionized by tremendous progress in the field of detection, characterization, survival prediction and monitoring during therapy. Recently, a particular attention has been given to radiomics for the characterization of GISTs using analysis of quantitative imaging features. In addition, radiomics has currently many applications that are developed in conjunction with artificial intelligence with the aim of better characterizing GISTs and providing a more precise assessment of tumor burden. This article sums up recent advances in computed tomography and magnetic resonance imaging of GISTs in the field of image/data acquisition, tumor detection, tumor characterization, treatment response evaluation, and preoperative planning.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-06-30T04:44:41Z
DOI: 10.1177/08465371231180510
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- Deep Learning Reconstruction Plus Single-Energy Metal Artifact Reduction
for Supra Hyoid Neck CT in Patients With Dental Metals-
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Authors: Masumi Mizuki, Koichiro Yasaka, Rintaro Miyo, Yuta Ohtake, Akiyoshi Hamada, Reina Hosoi, Osamu Abe
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: We investigated the effect of deep learning reconstruction (DLR) plus single-energy metal artifact reduction (SEMAR) on neck CT in patients with dental metals, comparing it with DLR and with hybrid iterative reconstruction (Hybrid IR)–SEMAR. Methods: In this retrospective study, 32 patients (25 men, 7 women; mean age: 63 ± 15 years) with dental metals underwent contrast-enhanced CT of the oral and oropharyngeal regions. Axial images were reconstructed using DLR, Hybrid IR–SEMAR, and DLR-SEMAR. In quantitative analyses, degrees of image noise and artifacts were evaluated. In one-by-one qualitative analyses, 2 radiologists evaluated metal artifacts, the depiction of structures, and noise on five-point scales. In side-by-side qualitative analyses, artifacts and overall image quality were evaluated by comparing Hybrid IR–SEMAR with DLR-SEMAR. Results: Artifacts were significantly less with DLR-SEMAR than with DLR in quantitative (P < .001) and one-by-one qualitative (P < .001) analyses, which resulted in significantly better depiction of most structures (P < .004). Artifacts in side-by-side analysis and image noise in quantitative and one-by-one qualitative analyses (P < .001) were significantly less with DLR-SEMAR than with Hybrid IR–SEMAR, resulting in significantly better overall quality of DLR-SEMAR. Conclusions: Compared with DLR and Hybrid IR–SEMAR, DLR-SEMAR provided significantly better supra hyoid neck CT images in patients with dental metals.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-06-30T01:20:26Z
DOI: 10.1177/08465371231182904
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- The Role of Twitter in Radiology Medical Education and Research: A Review
of Current Practices and Drawbacks-
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Authors: Benjamin D. Katzman, Nataly Farshait, Michael N. Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
The trends in society have provided favourable conditions for the rapid growth of radiology on social media, specifically there has been an expanding presence on Twitter. Currently, simple searches on Twitter yield a plethora of radiology education resources, that may be suited for medical students, residents or practicing radiologists. Educators have many tools at their disposal to deliver effective teaching. Over time, strategies such as including images and scrollable stacks often are more successful at gaining popularity or clicks online. Journals and authors can use Twitter to promote their new scientific work and potentially reach audiences they couldn’t have prior. Attendees at conferences can get involved in the conversation by tweeting about the meeting and engaging with other attendees with mutual interests. Interested medical students, residents and even practicing radiologists can use Twitter as a means of networking and connecting with other scholars all around the globe. Within its glory, Twitter does carry some drawbacks including privacy concerns, equality, and risk of misinformation. Above all, the future of Twitter is bright and promising for all who are currently on it and plan to use it for their education, research, or professional advancement.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-06-28T03:51:26Z
DOI: 10.1177/08465371231180643
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- Evaluating the Outcomes and Trainee Performance of a Canadian Medical
Imaging Clinician Investigator Program-
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Authors: Brian Tsang, Mohammed Aakef, Armin Nourmohammad, Jennifer R. McKinney, Mana Modares, Mark Levine, Benjamin Alman, Alan R. Moody, Andrea S. Doria
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: To measure the research productivity of trainees from the University of Toronto’s Medical Imaging Clinician Investigator Program (MI-CIP) and comparing it with the research productivity of trainees from MI-non-CIP and General Surgery (GSx) Clinician Investigator Program. Methods: We identified residents who completed an MI-CIP, MI-non-CIP and GSx-CIP from 2006-2016. In each group of trainees, we assessed 3 research productivity outcomes with non-parametric tests before residency and at 7 years post-CIP completion/post-graduation. Research productivity outcomes include the number of total publications, the number of first-author publications, and the publication’s average journal impact factor (IF). Results: We identified 11 MI-CIP trainees (male/female: 9 [82%]/2 [18%]), 74 MI-non-CIP trainees (46 [62%]/28 [38%]) and 41 GSx-CIP trainees (23 [56%]/18 [44%]). MI-CIP trainees had statistically significant higher research productivity than MI-non-CIP in all measured outcomes. The median (interquartile range, IQR) number of total publications of MI-CIP vs MI-non-CIP trainees was 5.0 (8.0) vs 1.0 (2.0) before residency and 6.0 (10.0) vs .0 (2.0) at 7 years post-CIP completion/post-graduation. The median (IQR) first-author publications of MI-CIP vs MI-non-CIP trainees was 2.0 (3.0) vs .0 (1.0) before residency and 2.0 (4.0) vs (.0) (1.0) at 7 years post-CIP completion/post-graduation. The median (IQR) average journal IF of MI-CIP vs MI-non-CIP trainees was 3.2 (2.0) vs .3 (2.4) before residency and 3.9 (3.2) vs .0 (2.6) at 7 years post-CIP completion/post-graduation. Between MI-CIP and GSx-CIP trainees, there were no significant differences in research productivity in all measured outcomes. Conclusion: MI-CIP trainees actively conducted research after graduation. These trainees demonstrated early research engagement before residency. The similar research productivity of MI-CIP vs GSx-CIP trainees shows initial success of MI-CIP trainees.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-06-22T03:19:00Z
DOI: 10.1177/08465371231181484
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- MRI Markers of Degenerative Disc Disease in Young Patients With Multiple
Sclerosis-
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Authors: Nima Omid-Fard, Rebecca E. Thornhill, Carlos Torres, Taleb M. Almansoori, Carolina A.E. Rush, Rafael Glikstein
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Background and Purpose: Evidence has emerged for an association between degenerative disc disease (DDD) and multiple sclerosis (MS). The purpose of the current study is to determine the presence and extent of cervical DDD in young patients (age
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-06-20T05:43:17Z
DOI: 10.1177/08465371231180815
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- Current Practice Patterns, Challenges, and Need for Education in
Performing and Reporting Advanced Pelvic US and MRI to Investigate
Endometriosis: A Survey by the Canadian Association of Radiologists
Endometriosis Working Group-
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Authors: Priscila Sacilotto Crivellaro, Iffat Rehman, Silvia Chang, Shauna Duigenan, Signy Holmes, Casey Hurrell, Ania Z. Kielar, Mathew Leonardi, Emily Pang, Arvind Shergill, Basma Al-Arnawoot
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: The Canadian Association of Radiologists (CAR) Endometriosis Working Group developed a national survey to evaluate current practice patterns associated with imaging endometriosis using advanced pelvic ultrasound and MRI to inform forthcoming clinical practice guidelines for endometriosis imaging. Methods: The anonymous survey consisted of 36 questions and was distributed electronically to CAR members. The survey contained a mix of multiple choice, Likert scale and open-ended questions intended to collect information about training and certification, current practices and protocols associated with imaging endometriosis, opportunities for quality improvement and continuing professional development. Descriptive statistics were used to summarize the results. Results: Canadian radiologists were surveyed about their experience with imaging endometriosis. A total of 89 responses were obtained, mostly from Ontario and Quebec. Most respondents were community radiologists, and almost 33% were in their first five years of practice. Approximately 38% of respondents reported that they or their institution performed advanced pelvic ultrasound for endometriosis, with most having done so for less than 5 years, and most having received training during residency or fellowship. 70% of respondents stated they currently interpret pelvic endometriosis MRI, with most having 1-5 years of experience. Conclusion: Many radiologists in Canada do not perform dedicated imaging for endometriosis. This may be due to a lack of understanding of the benefits and limited access to training. However, dedicated imaging can improve patient outcomes and decrease repeated surgeries. The results highlight the importance of developing guidelines for these imaging techniques and promoting a multidisciplinary approach to endometriosis management.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-06-20T02:49:40Z
DOI: 10.1177/08465371231179292
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- Prevalence of ‘Fat-Poor’ Adrenal Adenomas at Chemical-Shift
MRI.-
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Authors: Meshary Aldhufian, Jana Sheinis Pickovsky, Hana Alfaleh, Gerd Melkus, Nicola Schieda
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Objective: To determine the prevalence of ‘fat-poor’ adrenal adenomas at chemical-shift-MRI.Materials and Methods: This prospective IRB approved study identified 104 consecutive patients with 127 indeterminate adrenal masses that underwent 1.5-T chemical-shift-MRI between 2021-2023. Two blinded radiologists independently measured: 1) 2-Dimensionsal (2D) chemical-shift signal intensity (SI)-index on 2D Chemical-shift-MRI (SI-index>16.5% diagnosed presence of microscopic fat), 2) unenhanced CT attenuation (in cases where unenhanced CT was available).Results: From 127 adrenal masses, there were 94% (119/127) adenomas and 6% (8/127) other masses (2 pheochromocytoma, 5 metastases, 1 lymphoma). 98% (117/119) adenomas had SI-Index>16.5%, only 2% (2/119) adenomas were ‘fat-poor’ by MRI. SI-Index>16.5% was 100% specific for adenoma, all other masses had SI-Index 10 HU). Percentage of adenomas with SI-Index>16.5% were: 1) ≤10 HU, 100% (33/33), 2) 11-29 HU, 100% (12/12), 3) ≥30 HU, 60% (3/5). No other masses had attenuation ≤10 HU (0/5).Conclusion: Fat-poor adrenal adenomas are uncommon using 2D chemical-shift signal intensity index>16.5% at 1.5-T, occurring in approximately 2% of adenomas in this large prospective series.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-06-19T03:42:10Z
DOI: 10.1177/08465371231179881
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- Characterizing the Variety of Call Structures Across Canadian Diagnostic
Radiology Postgraduate Medical Education Programs-
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Authors: Hang Yu, Niharika Shahi, Sébastien Christian Robert, Alanna Supersad, Alexander Anishchenko, Kiana Lebel, Jessica L. Dobson, Michael N. Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-06-14T06:10:35Z
DOI: 10.1177/08465371231182415
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- Response to ChatGPT in Radiology: A Deeper Look Into its Limitations and
Potential Pathways for Improvement-
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Authors: Matthias W. Wagner, Birgit B. Ertl-Wagner
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-06-07T09:28:32Z
DOI: 10.1177/08465371231181910
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- Community-Based Breast Cancer Screening: A Grassroots Approach to Address
Racial Disparities in Detection and Diagnosis-
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Authors: Sonali Sharma, Michael Patlas, Charlotte J. Yong-Hing
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-05-25T07:45:40Z
DOI: 10.1177/08465371231180311
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- Non-Enhancing Tissue on Diabetic Foot Magnetic Resonance Imaging in
Relation to Osteomyelitis Investigation: Magnetic Resonance Imaging
Performance, Pitfalls and Clinical Considerations-
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Authors: Juvel Lee, Bruce B. Forster
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-05-22T04:03:47Z
DOI: 10.1177/08465371231179461
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- Automated MRI Protocolling and Scheduling: A Multi-Institutional Survey
and Results-
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Authors: Pratik Gajiwala, Kyle Eckhardt, Adnan Sheikh, Khaldon Abbas, Emily Davies, William Parker
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-05-22T03:18:08Z
DOI: 10.1177/08465371231176550
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- Abdominal Emergencies in Cancer Patients
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Authors: Mariano Scaglione, Salvatore Masala, Stefania Tamburrini, Giulia Lassandro, Luigi Barbuto, Luigia Romano, Francesca Iacobellis, Giacomo Sica, Paola Crivelli, Davide Turilli, Fabio Sandomenico, Vincenza Granata, Michael N Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Abdominal emergencies in cancer patients encompass a wide spectrum of oncologic conditions caused directly by malignancies, paraneoplastic syndromes, reactions to the chemotherapy or often represent the first clinical manifestation of an unknown malignancy. Not rarely, clinical symptoms are the tip of an iceberg. In this scenario, the radiologist is asked to exclude the cause responsible for the patient’s symptoms, to suggest the best way to manage and to rule out the underlying malignancy. In this article, we discuss some of the most common abdominal oncological emergencies that may be encountered in an emergency department.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-05-16T06:57:44Z
DOI: 10.1177/08465371231175521
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- Recommendations for Improvement of Equity, Diversity, and Inclusion in the
CaRMs Selection Process-
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Authors: Jana Taylor, Sonali Sharma, Alanna Supersad, Elka Miller, Kiana Lebel, Joanne Zabihaylo, Phyllis Glanc, Andrea S. Doria, Paula Cashin, Tracey Hillier, Charlotte J. Yong-Hing
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Equity, diversity and inclusion (EDI) in the medical field is crucial for meeting the healthcare needs of a progressively diverse society. A diverse physician workforce enables culturally sensitive care, promotes health equity, and enhances the comprehension of the various needs and viewpoints of patients, ultimately resulting in more effective treatments and improved patient outcomes. However, despite the recognized benefits of diversity in the medical field, certain specialties, such as Radiology, have struggled to achieve adequate equity, diversity and inclusion, which results in a discrepancy in the demographics of Canadian radiologists and the patients we serve. In this review, we propose strategies from a committee within the Canadian Association of Radiologists (CAR) EDI working group to improve EDI in the CaRMS selection process. By adopting these strategies, residency programs can foster a more diverse and inclusive environment that is better positioned to address the health needs of a progressively diverse patient population, leading to improved patient outcomes, greater patient satisfaction, and advancements in medical innovation.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-05-13T05:08:02Z
DOI: 10.1177/08465371231174897
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- ChatGPT in Radiology: A Deeper Look Into its Limitations and Potential
Pathways for Improvement-
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Authors: Partha Pratim Ray, Poulami Majumder
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-05-12T11:42:30Z
DOI: 10.1177/08465371231177674
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- Editor’s Corner: November 2023
-
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Authors: Jacky C. K. Chow, Michael N. Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-05-09T01:56:54Z
DOI: 10.1177/08465371231176726
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- The Rising Utilization of Opportunistic CT Screening and Machine Learning
in Bone Mineral Density-
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Authors: Nicholas M. Beckmann
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-05-06T07:42:05Z
DOI: 10.1177/08465371231176716
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- Watching Innovation in Real Time: The Story of ChatGPT and Radiology
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Authors: Elliot K. Fishman, William B. Weeks, Juan M. Lavista Ferres, Linda C. Chu
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-05-04T03:48:32Z
DOI: 10.1177/08465371231174817
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- Advanced Imaging Technology: Photon Counting CT
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Authors: Sabeena Jalal, Savvas Nicolaou
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-29T11:30:03Z
DOI: 10.1177/08465371231172738
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- Accuracy of Information and References Using ChatGPT-3 for Retrieval of
Clinical Radiological Information-
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Authors: Matthias W. Wagner, Birgit B. Ertl-Wagner
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: To assess the accuracy of answers provided by ChatGPT-3 when prompted with questions from the daily routine of radiologists and to evaluate the text response when ChatGPT-3 was prompted to provide references for a given answer. Methods: ChatGPT-3 (San Francisco, OpenAI) is an artificial intelligence chatbot based on a large language model (LLM) that has been designed to generate human-like text. A total of 88 questions were submitted to ChatGPT-3 using textual prompt. These 88 questions were equally dispersed across 8 subspecialty areas of radiology. The responses provided by ChatGPT-3 were assessed for correctness by cross-checking them with peer-reviewed, PubMed-listed references. In addition, the references provided by ChatGPT-3 were evaluated for authenticity. Results: A total of 59 of 88 responses (67%) to radiological questions were correct, while 29 responses (33%) had errors. Out of 343 references provided, only 124 references (36.2%) were available through internet search, while 219 references (63.8%) appeared to be generated by ChatGPT-3. When examining the 124 identified references, only 47 references (37.9%) were considered to provide enough background to correctly answer 24 questions (37.5%). Conclusion: In this pilot study, ChatGPT-3 provided correct responses to questions from the daily clinical routine of radiologists in only about two thirds, while the remainder of responses contained errors. The majority of provided references were not found and only a minority of the provided references contained the correct information to answer the question. Caution is advised when using ChatGPT-3 to retrieve radiological information.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-20T10:50:18Z
DOI: 10.1177/08465371231171125
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- Opportunistic Extraction of Quantitative CT Biomarkers: Turning the
Incidental Into Prognostic Information-
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Authors: Mohammad Nazri Md Shah, Raja Rizal Azman, Wai Yee Chan, Kwan Hoong Ng
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
The past two decades have seen a significant increase in the use of CT, with a corresponding rise in the mean population radiation dose. This rise in CT use has caused improved diagnostic certainty in conditions that were not previously routinely evaluated using CT, such as headaches, back pain, and chest pain. Unused data, unrelated to the primary diagnosis, embedded within these scans have the potential to provide organ-specific measurements that can be used to prognosticate or risk-profile patients for a wide variety of conditions. The recent increased availability of computing power, expertise and software for automated segmentation and measurements, assisted by artificial intelligence, provides a conducive environment for the deployment of these analyses into routine use. Data gathering from CT has the potential to add value to examinations and help offset the public perception of harm from radiation exposure. We review the potential for the collection of these data and propose the incorporation of this strategy into routine clinical practice.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-19T08:45:52Z
DOI: 10.1177/08465371231171700
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- T1 and T2 Mapping - A New Road to the Diagnosis of Anterior Mediastinal
Lesions'-
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Authors: Carolina A Souza
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-18T12:38:56Z
DOI: 10.1177/08465371231172412
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- Non-Enhancing Tissue on Diabetic Foot Magnetic Resonance Imaging in
Relation to Osteomyelitis Investigation: Magnetic Resonance Imaging
Performance, Pitfalls and Clinical Considerations-
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Authors: Inas Slim, Aisin Ibrahim, Sooheib Andoulsi, Charles-Antoine Beaulieu, Véronique Freire
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Background: Geographic non-enhancing zones in diabetic foot magnetic resonance imaging (MRI) were first described in 2002. No previous report has described the impact and clinical significance of geographic non-enhancing tissue seen in the evaluation of diabetic foot MRI. Purpose: To evaluate the prevalence of devascularization areas on contrast-enhanced MRI in diabetic patients suspected of having foot osteomyelitis, the impact on the performance of the MRI assessment, and the possible pitfalls. Methods: A retrospective study was conducted between January 2016 and December 2017 during which 72 CE-MRIs of 1.5 and 3T were reviewed by 2 musculoskeletal radiologists for the presence of non-enhancing tissue areas and for osteomyelitis. A blinded third party collected clinical data including pathology reports, revascularization procedures, and surgical interventions. The prevalence of devascularization was calculated. Results: Among the 72 CE-MRIs (54 men, 18 women; mean age 64), 28 demonstrated non-enhancing areas (39%). All but 6 patients were found to have been correctly diagnosed on imaging (3 false positives, 2 false negatives, and 1 non-diagnostic). A greater discordance was also observed between the radiological and pathological diagnoses in the MRIs which showed non-enhancing tissue. Conclusion: Non-enhancing tissue is found in a non-negligible portion of diabetic foot MRIs and affects its diagnostic performance when looking for osteomyelitis. The recognition of these areas of devascularization may be helpful for the physician in planning the best treatment option for the patient.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-18T03:07:18Z
DOI: 10.1177/08465371231167595
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- Clinical Features, Non-Contrast CT Radiomic and Radiological Signs in
Models for the Prediction of Hematoma Expansion in Intracerebral
Hemorrhage-
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Authors: Zejia Frank Chen, Liying Zhang, André M Carrington, Rebecca Thornhill, Olivier Miguel, Angela M Auriat, Nima O Fard, Shiva Hiremath, Vered Tshemeister Abitbul, Dar Dowlatshahi, Andrew Demchuk, David Gladstone, Andrea Morotti, Ilaria Casetta, Enrico Fainardi, Thien Huynh, Marah Elkabouli, Zoé Talbot, Gerd Melkus, Richard I Aviv
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
PurposeRapid identification of hematoma expansion (HE) risk at baseline is a priority in intracerebral hemorrhage (ICH) patients and may impact clinical decision making. Predictive scores using clinical features and Non-Contract Computed Tomography (NCCT)-based features exist, however, the extent to which each feature set contributes to identification is limited. This paper aims to investigate the relative value of clinical, radiological, and radiomics features in HE prediction.MethodsOriginal data was retrospectively obtained from three major prospective clinical trials [“Spot Sign” Selection of Intracerebral Hemorrhage to Guide Hemostatic Therapy (SPOTLIGHT)NCT01359202; The Spot Sign for Predicting and Treating ICH Growth Study (STOP-IT)NCT00810888] Patients baseline and follow-up scans following ICH were included. Clinical, NCCT radiological, and radiomics features were extracted, and multivariate modeling was conducted on each feature set.Results317 patients from 38 sites met inclusion criteria. Warfarin use (p=0.001) and GCS score (p=0.046) were significant clinical predictors of HE. The best performing model for HE prediction included clinical, radiological, and radiomic features with an area under the curve (AUC) of 87.7%. NCCT radiological features improved upon clinical benchmark model AUC by 6.5% and a clinical & radiomic combination model by 6.4%. Addition of radiomics features improved goodness of fit of both clinical (p=0.012) and clinical & NCCT radiological (p=0.007) models, with marginal improvements on AUC. Inclusion of NCCT radiological signs was best for ruling out HE whereas the radiomic features were best for ruling in HE.ConclusionNCCT-based radiological and radiomics features can improve HE prediction when added to clinical features.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-18T01:07:58Z
DOI: 10.1177/08465371231168383
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- Disparities in Radiologist Fee-For-Service Payments by Gender in Canada
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Authors: Hayley McKee, Cynthia Walsh, Mana Modares, Wan Wan Yap, Natalia Gorelik, Maura Brown, Charlotte J Yong-Hing, Kate Hanneman
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Objective: To examine differences in fee-for-service (FFS) payments to men and women radiologists in Canada and evaluate potential contributors. Methods: Publicly available FFS radiology billing data was analyzed from British Columbia (BC), Ontario (ON), Prince-Edward Island (PEI) and Nova Scotia (NS) between 2017 and 2021. Data was analyzed by gender on a per-province and national level. Variables evaluated included year, province, procedure billings, and days worked (BC and ON only). The gender pay gap was expressed as the difference in mean billing payments between men and women divided by mean payments to men. Results: Data points from 8478 radiologist years were included (2474 [29%] women and 6004 [71%] men). The unadjusted difference in annual FFS billings between men and women was $126,657. Overall, payments to women were 81% of payments to men with a 19% gender pay gap. The difference in billings between men and women did not change significantly between 2017 and 2021 (range in gender pay gap, 17–21%) but did vary by province (highest gap NS). Compared to men, women worked fewer days per year (weighted mean 218 ± 29 vs 236 ± 25 days/year, P < .001, 8% difference). Conclusion: In an analysis of fee-for-service payments to radiologists in 4 Canadian provinces between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap. Payments were lower to women across all years evaluated. Women worked 8% fewer days per year on average than men, which did not fully account for the difference in FFS billing payments between men and women. Summary Statement: In an analysis of fee-for-service payments to Canadian radiologists between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap which is not fully accounted for by time spent working.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-17T09:42:16Z
DOI: 10.1177/08465371231170630
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- Corrigendum to “Low Tube Voltage Chest Computed Tomography With
Enhancement Using Low-Concentration Iodinated Contrast Media: Comparison
of 240 mg/mL Versus 300 mg/mL Iodinated Contrast Media”-
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Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-15T09:15:16Z
DOI: 10.1177/08465371231169347
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- Adverse Events Self-Reporting in Radiology:A New Avenue for Excellence
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Authors: Philippe Soyer, Michael N. Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-14T02:02:45Z
DOI: 10.1177/08465371231171597
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- Appropriateness of Recommendations Provided by ChatGPT to Interventional
Radiologists-
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Authors: Maxime Barat, Philippe Soyer, Anthony Dohan
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: The purpose of this study was to analyze the answers provided by ChatGPT to various questions in the field of interventional radiology (IR) and compare their correctness to a consensus of three interventional radiologists. Materials and Methods. Twenty questions were proposed to the online chat based ChatGPT about interventional radiology as indications for exams, complications and technical points. Answers were independently evaluated by 3 experts in interventional radiology with 10, 15 and 30 years or experiences and classified as correct, almost correct, or wrong. Results: Considering the consensus between the two IR, nine (9/20; 45%) were considered wrong, three (3/20; 15%) were considered almost correct and eight (8/20; 40%) were considered correct. Conclusion: ChatGPT can be useful in IR but the users must be aware of limitations such as too vague or inaccurate answers for the majority of questions.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-13T03:20:43Z
DOI: 10.1177/08465371231170133
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- Assessing the Effects of Deep Learning Reconstruction on Abdominal CT
Without Arm Elevation-
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Authors: Nana Fujita, Koichiro Yasaka, Akira Katayama, Yuta Ohtake, Mao Konishiike, Osamu Abe
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: To evaluate the effects of deep learning reconstruction (DLR) on image quality of abdominal computed tomography (CT) in patients without arm elevation compared with hybrid-iterative reconstruction (Hybrid-IR) and filtered back projection (FBP). Methods: In this retrospective study, axial images of 26 patients who underwent CT without arm elevation were reconstructed using DLR, Hybrid-IR, and FBP. Streak artifact index (SAI) was calculated by dividing the standard deviation of CT attenuation in the liver or spleen by that in fat. Two other blinded radiologists evaluated streak artifacts on images (in the liver, spleen, and kidney), depiction of liver vessels, subjective image noise, and overall quality. They were also asked to detect space-occupying lesions other than cysts in the liver, spleen, and kidney. Results: The SAI (liver/spleen) in DLR images was significantly reduced compared with Hybrid-IR and FBP. Regarding qualitative image analysis, streak artifacts in the 3 organs, qualitative image noise, and overall quality in DLR images were rated by both readers as significantly improved compared with Hybrid-IR (P ≤ .012) and FBP (P < .001). Both blinded readers detected more lesions on DLR images than on Hybrid-IR and FBP ones. Conclusion: DLR resulted in significantly better-quality abdominal CT images in patients scanned without elevating their arms with reducing streak artifacts compared with Hybrid-IR and FBP.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-12T04:43:00Z
DOI: 10.1177/08465371231169672
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- CAR Practice Statement on Advanced Pelvic Ultrasound for Endometriosis
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Authors: Basma Al-Arnawoot, Silvia Chang, Shauna Duigenan, Ania Z. Kielar, Mathew Leonardi
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
The Canadian Association of Radiologists (CAR) Endometriosis Working Group was tasked with providing guidance and benchmarks to ensure the quality of technique and interpretation for advanced imaging modalities associated with diagnosing endometriosis. This practice statement provides an overview of the state of the art of advanced pelvic ultrasound in the diagnosis and mapping of pelvic endometriosis. While acknowledging that advanced pelvic ultrasound in some practices falls within the scope of clinical colleagues rather than imaging departments, the statement seeks to guide radiologists interested in implementing these techniques into their practice for patients referred for evaluation and diagnosis of endometriosis. The statement covers indications, some components of the ultrasound assessment and technique, reporting, and recommendations for starting an ultrasound endometriosis evaluation program.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-12T02:18:55Z
DOI: 10.1177/08465371231165986
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- Equity, Diversity and Inclusion in Radiology: Prioritizing Trainee
Involvement-
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Authors: Sonali Sharma, Michael Patlas, Faisal Khosa, Charlotte J. Yong-Hing
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-10T02:07:00Z
DOI: 10.1177/08465371231170230
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- Retrospective Evaluation of Splenic Artery Embolization Outcomes in the
Management of Blunt Splenic Trauma: A Single Centre Experience at a Large
Level 1 Trauma Centre-
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Authors: C O’Rourke, H McKee, DO Wijeyaratnam, J Bajwa, L Tremblay, E David
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
PurposeRetrospective review of splenic artery embolization (SAE) outcomes performed for blunt abdominal trauma.Materials and Methods11-year retrospective review at a large level-1 Canadian trauma centre. All patients who underwent SAE after blunt trauma were included. Technical success was defined as angiographic occlusion of the target vessel and clinical success was defined as successful non-operative management and splenic salvage on follow-up.Results138 patients were included of which 68.1% were male. The median age was 47 years (interquartile range (IQR) = 32.5 years). The most common mechanisms of injury were motor vehicle accidents (37.0%), mechanical falls (25.4%), and pedestrians hit by motor vehicles (10.9%). 70.3% of patients had American Association for the Surgery of Trauma (AAST) grade 4 injuries. Patients were treated with proximal SAE (n = 97), distal SAE (n = 23) or combined SAE (n = 18), and 68% were embolized with an Amplatzer plug. No significant differences were observed across all measures of hospitalization (Length of hospital stay: x2(2) = .358, P = .836; intensive care unit (ICU) stay: x2(2) = .390, P = .823; ICU stay post-procedure: x2(2) = 1.048, P = .592). Technical success and splenic salvage were achieved in 100% and 97.8% of patients, respectively. 7 patients (5%) had post-embolization complications and 7 patients (5%) died during hospital admission, but death was secondary to other injuries sustained in the trauma rather than complications related to splenic injury or its management.ConclusionWe report that SAE as an adjunct to non-operative management of blunt splenic trauma can be performed safely and effectively with a high rate of clinical success.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-07T11:03:54Z
DOI: 10.1177/08465371231166946
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- Typology, Severity, and Outcomes of Adverse Events Related to Angiographic
Equipment—A Ten-Year Analysis of the FDA MAUDE Database-
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Authors: Gerard M. Healy, Aida Ahrari, Fahd Alkhalifah, George Oreopoulos, Kong Teng Tan, Arash Jaberi, Sebastian Mafeld
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: Angiographic equipment is a key component of healthcare infrastructure, used for endovascular procedures throughout the body. The literature on adverse events related to this technology is limited. The purpose of this study was to analyze adverse events related to angiographic devices from the US Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database. Methods: MAUDE data on angiographic imaging equipment from July 2011 to July 2021 were extracted. Qualitative content analysis was performed, a typology of adverse events was derived, and this was used to classify the data. Outcomes were assessed using the Healthcare Performance Improvement (HPI) and Society of Interventional Radiology (SIR) adverse event classifications. Results: There were 651 adverse events reported. Most were near misses (67%), followed by precursor safety events (20.5%), serious safety events (11.2%), and unclassifiable (1.2%). Events impacted patients (42.1%), staff (3.2%), both (1.2%), or neither (53.5%). The most common events associated with patient harm were intra-procedure system shut down, foot pedal malfunction, table movement malfunction, image quality deterioration, patient falls, and fluid damage to system. Overall, 34 (5.2%) events were associated with patient death; 18 during the procedure and 5 during patient transport to another angiographic suite/hospital due to critical failure of equipment. Conclusion: Adverse events related to angiographic equipment are rare; however, serious adverse events and deaths have been reported. This study has defined a typology of the most common adverse events associated with patient and staff harm. Increased understanding of these failures may lead to improved product design, user training, and departmental contingency planning.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-06T10:02:55Z
DOI: 10.1177/08465371231167990
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- Canadian Association of Radiologists Diagnostic Imaging Referral
Guidelines-
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Authors: Candyce Hamel, Marc Venturi, Ryan Margau, Paul Pageau
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-05T04:38:01Z
DOI: 10.1177/08465371231169746
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- Optimising Outpatient Oral Contrast Use in Abdominal CT–A Radiology
Pandemic Response Initiative to Reduce Patient Time in the Waiting Room
and Reduce Costs, While Improving Patient Experience-
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Authors: Mary Renton, Ania Z. Kielar, Daniel Toubassy, Mary May, Manjula Maganti, Corwin Burton, Satheesh Krishna
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: The aim was to reduce outpatient wait time and improve patient experience by optimising oral contrast use. Methods: Our multidisciplinary stakeholder collaboration implemented two simultaneous interventions: (1) Creation of ‘oral contrast policy’, limiting recommended indications. (2) Creation of a new shorter oral contrast regime (30 vs 60 min). We conducted a retrospective service evaluation of oral contrast use in outpatient (OP) abdominal CT at baseline and post-intervention. Patient wait times were measured and per-patient cost-savings were reported. An image quality review was performed by 2 blinded abdominal radiologists. Patient experience was evaluated with a standard voluntary survey. Statistical analysis was performed comparing baseline and evaluation outcomes using Chi-square or Fisher Exact test for categorical variables and Student’s t-test or ANOVA for continuous data. Results: Over 1-month periods, OP CT scans were assessed in baseline (pre-pandemic) n = 575, baseline (pandemic) n = 495 and post-intervention n = 545 groups. Oral contrast use reduced from 420/575, 73.0% at baseline to 178/545, 32.7% post intervention. The turn-around time reduced by 15.8 minutes per patient from 70.3 to 54.5 minutes, P < .001 (Interventions 1 and 2). The diagnostic quality did not differ between the oral contrast regimes (Intervention 2, P = 1.0, P = .08). No repeat CTs were needed due to lack of oral contrast (Intervention 1) or poor opacification (Intervention 2). There was oral contrast cost reductions of 69.1–78.4% (P < .001). Patients reported their overall experience was improved post-intervention (Interventions 1 and 2). Conclusions: Optimising the CT oral contrast service through judicious use and a shorter regime, reduced patient wait times, improved patient experience and preserved diagnostic quality.Summary statementOptimising the CT oral contrast service through judicious use and a shorter regime, reduced patient wait-times, improved patient experience and preserved diagnostic quality.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-04-03T11:29:28Z
DOI: 10.1177/08465371231166381
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- Machine Learning for Opportunistic Screening for Osteoporosis and
Osteopenia Using Knee CT Scans-
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Authors: Ronnie Sebro, Mahmoud Elmahdy
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
PurposeTo predict whether a patient has osteoporosis/osteopenia using the attenuation of trabecular bone obtained from knee computed tomography (CT) scans.MethodsRetrospective analysis of 273 patients who underwent contemporaneous knee CT scans and dual-energy X-ray absorptiometry (DXA) within 1 year. Volumetric segmentation of the trabecular bone of the distal femur, proximal tibia, patella, and proximal fibula was performed to obtain the bone CT attenuation. The data was randomly split into training/validation (78%) and test (22%) datasets and the performance in the test dataset were evaluated. The predictive properties of the CT attenuation of each bone to predict osteoporosis/osteopenia were assessed. Multivariable support vector machines (SVM) and random forest classifiers (RF) were used to predict osteoporosis/osteopenia.ResultsPatients with a mean age (range) of 67.9 (50–87) years, 85% female were evaluated. Seventy-seven (28.2%) of patients had normal bone mineral density (BMD), 140 (51.3%) had osteopenia, and 56 (20.5%) had osteoporosis. The proximal tibia had the best predictive ability of all bones and a CT attenuation threshold of 96.0 Hounsfield Units (HU) had a sensitivity of .791, specificity of .706, and area under the curve (AUC) of .748. The AUC for the SVM with cubic kernel classifier (AUC = .912) was better than the RF classifier (AUC = .683, P < .001) and better than using the CT attenuation threshold of 96.0 HU at the proximal tibia (AUC = .748, P = .025).ConclusionsOpportunistic screening for osteoporosis/osteopenia can be performed using knee CT scans. Multivariable machine learning models are more predictive than the CT attenuation of a single bone.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-03-24T11:17:50Z
DOI: 10.1177/08465371231164743
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- Automated Adolescence Scoliosis Detection Using Augmented U-Net With
Non-square Kernels-
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Authors: Yujie Wu, Khashayar Namdar, Chaojun Chen, Shahob Hosseinpour, Manohar Shroff, Andrea S. Doria, Farzad Khalvati
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: Scoliosis is a deformity of the spine, and as a measure of scoliosis severity, Cobb angle is fundamental to the diagnosis of deformities that require treatment. Conventional Cobb angle measurement and assessment is usually done manually, which is inherently time-consuming, and associated with high inter- and intra-observer variability. While there exist automatic scoliosis measurement methods, they suffer from insufficient accuracy. In this work, we propose a two-step segmentation-based deep learning architecture to automate Cobb angle measurement for scoliosis assessment using X-Ray images. Methods: The proposed architecture involves two steps. In the first step, we utilize a novel Augmented U-Net architecture to generate segmentations of vertebrae. The second step includes a non-learning-based pipeline to extract landmark coordinates from the segmented vertebrae and filter undesirable landmarks. Results: Our proposed Augmented U-Net architecture achieved a Symmetric Mean Absolute Percentage Error of 9.2%, with approximately 90% of estimations having less than 10 degrees difference compared with the AASCE-MICCAI challenge 2019 dataset ground truths. We further validated the model using an internal dataset and achieved almost the same level of performance. Conclusion: The proposed architecture is robust in providing automated spinal vertebrae segmentations and Cobb angle measurement, and is potentially generalizable to real-world clinical settings.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-03-23T04:16:41Z
DOI: 10.1177/08465371231163187
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- Retrospective Comparison of the Lateral-Arm and Vertical Needle Approaches
for Prone Tomosynthesis-Guided Breast Biopsy-
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Authors: Ethan O. Cohen, Olena Weaver, Katrina E. Korhonen, Jia Sun, Jessica W.T. Leung
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-03-22T07:53:26Z
DOI: 10.1177/08465371231164601
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- Intra-Specialty Citation Pattern in Radiology and
Gastroenterology/Hepatology Journals: A Cross-Specialty Comparison-
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Authors: Bo Gong, Philippe Soyer, Matthew DF McInnes, Michael N. Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Objectives: To investigate intra-specialty citation patterns of radiology articles, compared with another medical specialty: gastroenterology/hepatology. Methods: Four radiology journals (Radiology, European Radiology, Diagnostic and Interventional Imaging, Canadian Association of Radiologists Journal) and four gastroenterology/hepatology journals (Journal of Hepatology, Journal of Gastroenterology, World Journal of Gastroenterology, Journal of Clinical Gastroenterology) with similar Web of Science in-category 2020 IF ranking were selected. The original research, review, letter, and editorial articles published in these journals in 2021 were identified. The average number of intra-specialty citations per article (intra-specialty citation count) and percentage of intra-specialty citations out of total citations per article (intra-specialty citation rate) were compared between radiology and gastroenterology/hepatology articles using Student’s t-test. Results: The radiology articles demonstrated a lower total citation count per article (radiology: 29.7 ± .4 (mean ± SEM), n = 2063; gastroenterology/hepatology: 50.1 ± 1.4, n = 1335). The intra-specialty citation count was also lower in radiology articles than gastroenterology/hepatology articles (radiology: 12.9 ± .2, gastroenterology/hepatology: 19.6 ± .7; P < .001), both overall and in all article types. Additionally, the overall intra-specialty citation rate was not significantly different between the two specialties (radiology: 48.8% ± .5%; gastroenterology/hepatology: 47.1 ± .8%; P = .057), although the intra-specialty citation rates were higher in radiology original research and editorial article types. Conclusions: The significantly lower per-article intra-specialty citation counts in all radiology article types, a measurement that directly links to specialty IFs, may contribute to the lower impact factors of radiology journals compared with gastroenterology/hepatology ones.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-03-21T09:40:42Z
DOI: 10.1177/08465371231163239
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- Response to Editorial Entitled: Ovarian-Adnexal Reporting and Data System
for Ultrasound: A Framework for Improvement-
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Authors: Catherine H. Phillips, Loretta M. Strachowski, Caroline Reinhold, Rochelle F. Andreotti
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-03-17T05:29:23Z
DOI: 10.1177/08465371231162630
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- MI-RADS: An Innovative Mentorship Initiative to Improve Gender Disparity
in Application to Diagnostic Radiology-
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Authors: Alexandra Silver, Helena Bentley, Kathryn E. Darras, Alexandra T. Vertinsky
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-03-11T01:20:00Z
DOI: 10.1177/08465371231160999
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- T1 and T2 Mapping for Characterization of Mediastinal Masses: A
Feasibility study-
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Authors: Kyongmin S. Beck, Suyon Chang, Kwanyong Hyun, Yeoun Eun Sung, Kyo-Young Lee, Jung Im Jung
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: To evaluate the feasibility and usefulness of T1 and T2 mapping in characterization of mediastinal masses. Methods: From August 2019 through December 2021, 47 patients underwent 3.0-T chest MRI with T1 and post-contrast T1 mapping using modified look-locker inversion recovery sequences and T2 mapping using a T2-prepared single-shot shot steady-state free precession technique. Mean native T1, native T2, and post-contrast T1 values were measured by drawing the region of interest in the mediastinal masses, and enhancement index (EI) was calculated using these values. Results: All mapping images were acquired successfully, without significant artifact. There were 25 thymic epithelial tumors (TETs), 3 schwannomas, 6 lymphomas, and 9 thymic cysts, and 4 other cystic tumors. TET, schwannoma, and lymphoma were grouped together as “solid tumor,” to be compared with thymic cysts and other tumors (“cystic tumors”). The mean post-contrast T1 mapping (P < .001), native T2 mapping (P < .001), and EI (P < .001) values showed significant difference between these two groups. Among TETs, high risk TETs (thymoma types B2, B3, and thymic carcinoma) showed significantly higher native T2 mapping values (P = .002) than low risk TETs (thymoma types A, B1, and AB). For all measured variables, interrater reliability was good to excellent (intraclass coefficient [ICC]: .869∼.990) and intrarater reliability was excellent (ICC: .911∼.995). Conclusion: The use of T1 and T2 mapping in MRI of mediastinal masses is feasible and may provide additional information in the evaluation of mediastinal masses.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-03-08T03:39:32Z
DOI: 10.1177/08465371231160052
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- Risk Stratification for Oropharyngeal Squamous Cell Carcinoma Using
Texture Analysis on CT – A Step Beyond HPV Status-
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Authors: Yuh-Shin Chang, Jaykumar Raghavan Nair, Connor C. McDougall, Wu Qiu, Robyn Banerjee, Manish Joshi, John T. Lysack
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Background and Purpose: Human papillomavirus-associated oropharyngeal squamous cell carcinoma (OPSCC) is increasingly prevalent. Despite the overall more favorable outcome, the observed heterogeneous treatment response within this patient group highlights the need for additional means to prognosticate and guide clinical decision-making. Promising prediction models using radiomics from primary OPSCC have been derived. However, no model/s using metastatic lymphadenopathy exist to allow prognostication in those instances when the primary tumor is not seen. The aim of our study was to evaluate whether radiomics using metastatic lymphadenopathy allows for the development of a useful risk assessment model comparable to the primary tumor and whether additional knowledge of the HPV status further improves its prognostic efficacy. Materials and Methods: 80 consecutive patients diagnosed with stage III-IV OPSCC between February 2009 and October 2015, known human papillomavirus status, and pre-treatment CT images were retrospectively identified. Manual segmentation of primary tumor and metastatic lymphadenopathy was performed and the extracted texture features were used to develop multivariate assessment models to prognosticate treatment response. Results: Texture analysis of either the primary or metastatic lymphadenopathy from pre-treatment enhanced CT images can be used to develop models for the stratification of treatment outcomes in OPSCC patients. AUCs range from .78 to .85 for the various OPSCC groups tested, indicating high predictive capability of the models. Conclusions: This preliminary study can form the basis multi-centre trial that may help optimize treatment and improve quality of life in patients with OPSCC in the era of personalized medicine.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-03-01T12:05:15Z
DOI: 10.1177/08465371231157592
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- Editor’s Corner: August 2023
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Authors: Jacky C. K. Chow, Michael N. Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-03-01T03:28:39Z
DOI: 10.1177/08465371231160893
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- Competency-Based Medical Education in Radiology – Planning for the
Immediate and Long-Term Future of Radiology Education-
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Authors: Yoan K. Kagoma, Julian Dobranowski, Michael Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-02-14T11:29:24Z
DOI: 10.1177/08465371231157252
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- Corrigendum to “Canadian Radiology Gender Pay Gap-Reality or
Myth'”-
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Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-02-01T01:34:43Z
DOI: 10.1177/07334648221148561
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- Standardized Reporting on the Preoperative CT Assessment of Potential
Living Renal Transplant Donors: Can We Create a Universal Report Standard
to Meet the Needs of Transplant Urologists'-
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Authors: Hadas Benhabib, Priscila Sacilotto Crivellaro, Heba Osman, Senthujan Gunaseelan, Andrew Chung, Jason Y. Lee, Errol Colak, Vincent Leung, Joseph O’Sullivan, Cynthia Walsh, Ania Kielar
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Purpose: Determine whether standardized template reporting for the preoperative assessment of potential living renal transplant donors improves the comprehensiveness of radiology reports to meet the needs of urologists performing renal transplants. Methods: Urologist and radiologist stakeholders from renal transplant centers in our province ratified a standardized reporting template for evaluation of potential renal donors. Three centers (A, B, and C) were designated “intervention” groups. Center D was the control group, given employment of a site-specific standardized template prior to study commencement. Up to 100 consecutive CT scan reports per center, pre- and post-implementation of standardized reporting, were evaluated for reporting specific outcome measures. Results: At baseline, all intervention groups demonstrated poor reporting of urologist-desired outcome measures. Center A discussed 5/13 variables (38%), Center B discussed 6/13 variables (46%), and Center C only discussed 1/13 variables (8%) with ≥90% reliability. The control group exhibited consistent reporting, with 11/13 variables (85%) reported at ≥90% reliability. All institutions in the intervention group exhibited excellent compliance to structured reporting post-template implementation (Centers A = 95%, B = 100%, and C = 77%, respectively). Additionally, all intervention centers demonstrated a significant improvement in the comprehensiveness of reports post-template implementation, with statistically significant increases in the reporting of all variables under-reported at baseline (P> .01). Conclusion: Standardized templates across our province for CT scans of potential renal donors promote completeness of reports. Radiologists can reliably provide our surgical colleagues with needed preoperative anatomy and incidental findings, helping to determine suitable transplant donors and reduce potential complications associated with organ retrieval.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-01-31T10:19:07Z
DOI: 10.1177/08465371231153828
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- Provision of Culturally Competent Healthcare to Address Healthcare
Disparities-
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Authors: Charlotte J. Yong-Hing, Faisal Khosa
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-01-30T11:44:08Z
DOI: 10.1177/08465371231154231
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- Recommendations for the Management of Incidental Musculoskeletal Findings
on MRI and CT-
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Authors: Gina Di Primio, Gordon J. Boyd, Christopher I. Fung, Casey Hurrell, Gary L. Brahm, Jeffery R. Bird, Steven J. Co, Iain D. C. Kirkpatrick
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
The Canadian Association of Radiologists (CAR) Incidental Findings Working Group consists of both academic subspeciality and general radiologists tasked with either adapting American College of Radiology (ACR) guidelines to meet the needs of Canadian radiologists or authoring new guidelines where appropriate. In this case, entirely new guidelines to deal with incidental musculoskeletal findings that may be encountered on thoracoabdominal computed tomography or magnetic resonance imaging were drafted, focussing on which findings should prompt recommendations for further workup. These recommendations discuss how to deal with incidental marrow changes, focal bone lesions, abnormalities of the pubic symphysis and sacroiliac joints, fatty soft tissue masses, manifestations of renal osteodystrophy and finally discuss opportunistic osteoporosis evaluation.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-01-30T07:08:32Z
DOI: 10.1177/08465371231152151
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- The Role of Computed Tomography and Magnetic Resonance Imaging in Accurate
Size Estimation of Pancreatic Ductal Adenocarcinoma-
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Authors: Mostafa Alabousi, Michael N. Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-01-19T05:28:11Z
DOI: 10.1177/08465371231153030
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- Applications of Artificial Intelligence in Urological Oncology Imaging:
More Data Are Needed-
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Authors: Philippe Soyer, Anthony Dohan, Maxime Barat
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-01-11T08:31:41Z
DOI: 10.1177/08465371231152230
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- Learning Radiology AI Concepts by Seeing and Doing
-
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Authors: Bo Gong, Michael N. Patlas
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-01-09T03:26:08Z
DOI: 10.1177/08465371231151239
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- Screening with Breast Cancer Mammography: Re-Evaluation of Current
Evidence-
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Authors: Jean-Paul Salameh, Mohammed Kashif Al-Ghita, Matthew D. F. McInnes, Jean M. Seely
Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
Citation: Canadian Association of Radiologists Journal
PubDate: 2023-01-02T01:46:29Z
DOI: 10.1177/08465371221148134
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