Subjects -> CHEMISTRY (Total: 1001 journals)
    - ANALYTICAL CHEMISTRY (59 journals)
    - CHEMISTRY (726 journals)
    - CRYSTALLOGRAPHY (23 journals)
    - ELECTROCHEMISTRY (28 journals)
    - INORGANIC CHEMISTRY (45 journals)
    - ORGANIC CHEMISTRY (49 journals)
    - PHYSICAL CHEMISTRY (71 journals)

CHEMISTRY (726 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 735 Journals sorted alphabetically
Accounts of Materials Research     Hybrid Journal  
Accreditation and Quality Assurance: Journal for Quality, Comparability and Reliability in Chemical Measurement     Hybrid Journal   (Followers: 36)
ACS Applied Polymer Materials     Hybrid Journal   (Followers: 15)
ACS Catalysis     Hybrid Journal   (Followers: 78)
ACS Chemical Neuroscience     Hybrid Journal   (Followers: 25)
ACS Combinatorial Science     Hybrid Journal   (Followers: 25)
ACS Macro Letters     Hybrid Journal   (Followers: 34)
ACS Materials Letters     Open Access   (Followers: 4)
ACS Medicinal Chemistry Letters     Hybrid Journal   (Followers: 49)
ACS Nano     Hybrid Journal   (Followers: 452)
ACS Photonics     Hybrid Journal   (Followers: 19)
ACS Symposium Series     Full-text available via subscription   (Followers: 3)
ACS Synthetic Biology     Hybrid Journal   (Followers: 40)
Acta Chemica Iasi     Open Access   (Followers: 8)
Acta Chemica Malaysia     Open Access  
Acta Chimica Slovaca     Open Access   (Followers: 4)
Acta Chimica Slovenica     Open Access   (Followers: 2)
Acta Chromatographica     Full-text available via subscription   (Followers: 9)
Acta Facultatis Medicae Naissensis     Open Access   (Followers: 1)
Acta Metallurgica Sinica (English Letters)     Hybrid Journal   (Followers: 10)
Acta Scientifica Naturalis     Open Access   (Followers: 3)
adhäsion KLEBEN & DICHTEN     Hybrid Journal   (Followers: 9)
Adhesion Adhesives & Sealants     Hybrid Journal   (Followers: 10)
Adsorption Science & Technology     Open Access   (Followers: 9)
Advanced Electronic Materials     Hybrid Journal   (Followers: 7)
Advanced Functional Materials     Hybrid Journal   (Followers: 81)
Advanced Journal of Chemistry, Section A     Open Access   (Followers: 15)
Advanced Journal of Chemistry, Section B     Open Access   (Followers: 14)
Advanced Science Focus     Free   (Followers: 7)
Advanced Theory and Simulations     Hybrid Journal   (Followers: 5)
Advanced Therapeutics     Hybrid Journal   (Followers: 1)
Advances in Chemical Engineering and Science     Open Access   (Followers: 108)
Advances in Chemical Science     Open Access   (Followers: 50)
Advances in Chemistry     Open Access   (Followers: 39)
Advances in Chemistry     Full-text available via subscription   (Followers: 6)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 21)
Advances in Drug Research     Full-text available via subscription   (Followers: 27)
Advances in Environmental Chemistry     Open Access   (Followers: 11)
Advances in Enzyme Research     Open Access   (Followers: 13)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 20)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 11)
Advances in Materials Physics and Chemistry     Open Access   (Followers: 35)
Advances in Nanoparticles     Open Access   (Followers: 20)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 20)
Advances in Polymer Science     Hybrid Journal   (Followers: 54)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 19)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 22)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 7)
Advances in Science and Technology     Full-text available via subscription   (Followers: 17)
Aerosol Science and Engineering     Hybrid Journal  
African Journal of Bacteriology Research     Open Access  
African Journal of Chemical Education     Open Access   (Followers: 6)
African Journal of Pure and Applied Chemistry     Open Access   (Followers: 7)
Aggregate     Open Access   (Followers: 4)
Agrokémia és Talajtan     Full-text available via subscription   (Followers: 3)
Al-Kimia : Jurnal Penelitian Sains Kimia     Open Access  
Alchemy : Journal of Chemistry     Open Access   (Followers: 5)
Alchemy : Jurnal Penelitian Kimia     Open Access   (Followers: 2)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Alotrop     Open Access  
AMB Express     Open Access   (Followers: 1)
Ambix     Hybrid Journal   (Followers: 3)
American Journal of Biochemistry and Biotechnology     Open Access   (Followers: 71)
American Journal of Biochemistry and Molecular Biology     Open Access   (Followers: 24)
American Journal of Chemistry     Open Access   (Followers: 41)
American Journal of Plant Physiology     Open Access   (Followers: 13)
Analyst     Full-text available via subscription   (Followers: 40)
Analytical Science Advances     Open Access   (Followers: 2)
Angewandte Chemie     Hybrid Journal   (Followers: 235)
Angewandte Chemie International Edition     Hybrid Journal   (Followers: 352)
Annales Universitatis Mariae Curie-Sklodowska, sectio AA – Chemia     Open Access   (Followers: 1)
Annals of Clinical Chemistry and Laboratory Medicine     Open Access   (Followers: 8)
Annual Reports in Computational Chemistry     Full-text available via subscription   (Followers: 4)
Annual Reports Section A (Inorganic Chemistry)     Full-text available via subscription   (Followers: 6)
Annual Reports Section B (Organic Chemistry)     Full-text available via subscription   (Followers: 9)
Annual Review of Chemical and Biomolecular Engineering     Full-text available via subscription   (Followers: 13)
Annual Review of Food Science and Technology     Full-text available via subscription   (Followers: 16)
Antiviral Chemistry and Chemotherapy     Open Access   (Followers: 2)
Applied Organometallic Chemistry     Hybrid Journal   (Followers: 12)
Applied Spectroscopy     Full-text available via subscription   (Followers: 27)
Applied Surface Science     Hybrid Journal   (Followers: 33)
Arabian Journal of Chemistry     Open Access   (Followers: 6)
ARKIVOC     Open Access   (Followers: 1)
Asian Journal of Applied Chemistry Research     Open Access   (Followers: 2)
Asian Journal of Biochemistry     Open Access   (Followers: 3)
Asian Journal of Chemical Sciences     Open Access   (Followers: 1)
Asian Journal of Chemistry and Pharmaceutical Sciences     Open Access   (Followers: 2)
Asian Journal of Physical and Chemical Sciences     Open Access   (Followers: 3)
Atomization and Sprays     Full-text available via subscription   (Followers: 8)
Australian Journal of Chemistry     Hybrid Journal   (Followers: 7)
Autophagy     Hybrid Journal   (Followers: 7)
Avances en Quimica     Open Access  
Biochemical Pharmacology     Hybrid Journal   (Followers: 11)
Biochemistry     Hybrid Journal   (Followers: 483)
Biochemistry Insights     Open Access   (Followers: 7)
Biochemistry Research International     Open Access   (Followers: 6)
BioChip Journal     Hybrid Journal  
Bioinorganic Chemistry and Applications     Open Access   (Followers: 11)
Biointerface Research in Applied Chemistry     Open Access   (Followers: 3)
Biointerphases     Open Access   (Followers: 1)
Biology, Medicine, & Natural Product Chemistry     Open Access   (Followers: 4)
Biomacromolecules     Hybrid Journal   (Followers: 27)
Biomass Conversion and Biorefinery     Partially Free   (Followers: 11)
Biomedical Chromatography     Hybrid Journal   (Followers: 6)
Biomolecular NMR Assignments     Hybrid Journal   (Followers: 4)
BioNanoScience     Partially Free   (Followers: 6)
Bioorganic & Medicinal Chemistry     Hybrid Journal   (Followers: 215)
Bioorganic & Medicinal Chemistry Letters     Hybrid Journal   (Followers: 88)
Bioorganic Chemistry     Hybrid Journal   (Followers: 10)
Biopolymers     Hybrid Journal   (Followers: 18)
Biosensors     Open Access   (Followers: 4)
Biotechnic and Histochemistry     Hybrid Journal   (Followers: 1)
Bitácora Digital     Open Access  
Boletin de la Sociedad Chilena de Quimica     Open Access  
Bulletin of Institute of Chemistry and Chemical Technology, Mongolian Academy of Sciences     Open Access  
Bulletin of the Chemical Society of Ethiopia     Open Access   (Followers: 1)
Bulletin of the Chemical Society of Japan     Full-text available via subscription   (Followers: 26)
Bulletin of the Korean Chemical Society     Hybrid Journal   (Followers: 1)
C - Journal of Carbon Research     Open Access   (Followers: 5)
Cakra Kimia (Indonesian E-Journal of Applied Chemistry)     Open Access  
Canadian Association of Radiologists Journal     Full-text available via subscription   (Followers: 2)
Canadian Journal of Chemistry     Hybrid Journal   (Followers: 13)
Canadian Mineralogist     Full-text available via subscription   (Followers: 7)
Carbohydrate Polymer Technologies and Applications     Open Access   (Followers: 3)
Carbohydrate Polymers     Hybrid Journal   (Followers: 13)
Carbohydrate Research     Hybrid Journal   (Followers: 26)
Carbon     Hybrid Journal   (Followers: 76)
Catalysis Reviews: Science and Engineering     Hybrid Journal   (Followers: 9)
Catalysis Science and Technology     Hybrid Journal   (Followers: 13)
Catalysis Surveys from Asia     Hybrid Journal   (Followers: 4)
Catalysts     Open Access   (Followers: 14)
Cell Reports Physical Science     Open Access  
Cellulose     Hybrid Journal   (Followers: 17)
Cereal Chemistry     Full-text available via subscription   (Followers: 6)
ChemBioEng Reviews     Full-text available via subscription   (Followers: 3)
ChemCatChem     Hybrid Journal   (Followers: 11)
Chemical and Engineering News     Free   (Followers: 24)
Chemical Bulletin of Kazakh National University     Open Access  
Chemical Communications     Full-text available via subscription   (Followers: 88)
Chemical Engineering Research and Design     Hybrid Journal   (Followers: 28)
Chemical Physics Letters : X     Open Access   (Followers: 4)
Chemical Research in Chinese Universities     Hybrid Journal   (Followers: 4)
Chemical Research in Toxicology     Hybrid Journal   (Followers: 25)
Chemical Reviews     Hybrid Journal   (Followers: 266)
Chemical Science     Open Access   (Followers: 44)
Chemical Science International Journal     Open Access   (Followers: 1)
Chemical Technology     Open Access   (Followers: 71)
Chemical Vapor Deposition     Hybrid Journal   (Followers: 5)
Chemie in Unserer Zeit     Hybrid Journal   (Followers: 56)
Chemie-Ingenieur-Technik (Cit)     Hybrid Journal   (Followers: 23)
ChemInform     Hybrid Journal   (Followers: 9)
Chemistry     Open Access  
Chemistry & Biodiversity     Hybrid Journal   (Followers: 7)
Chemistry & Biology     Full-text available via subscription   (Followers: 31)
Chemistry & Industry     Full-text available via subscription   (Followers: 8)
Chemistry - A European Journal     Hybrid Journal   (Followers: 224)
Chemistry - An Asian Journal     Hybrid Journal   (Followers: 20)
Chemistry Africa : A Journal of the Tunisian Chemical Society     Hybrid Journal  
Chemistry and Materials Research     Open Access   (Followers: 24)
Chemistry Central Journal     Open Access   (Followers: 5)
Chemistry Education Research and Practice     Free   (Followers: 8)
Chemistry Education Review     Open Access   (Followers: 5)
Chemistry in Education     Open Access   (Followers: 9)
Chemistry Letters     Full-text available via subscription   (Followers: 49)
Chemistry of Heterocyclic Compounds     Hybrid Journal   (Followers: 4)
Chemistry of Materials     Hybrid Journal   (Followers: 337)
Chemistry of Natural Compounds     Hybrid Journal   (Followers: 10)
Chemistry World     Full-text available via subscription   (Followers: 20)
Chemistry-Didactics-Ecology-Metrology     Open Access   (Followers: 1)
ChemistryOpen     Open Access   (Followers: 1)
ChemistrySelect     Hybrid Journal  
Chemistry–Methods     Open Access   (Followers: 2)
Chemkon - Chemie Konkret, Forum Fuer Unterricht Und Didaktik     Hybrid Journal  
ChemNanoMat     Hybrid Journal   (Followers: 1)
Chemoecology     Hybrid Journal   (Followers: 3)
Chemometrics and Intelligent Laboratory Systems     Hybrid Journal   (Followers: 14)
Chemosensors     Open Access   (Followers: 1)
ChemPhotoChem     Hybrid Journal  
ChemPhysChem     Hybrid Journal   (Followers: 14)
ChemPlusChem     Hybrid Journal   (Followers: 2)
Chempublish Journal     Open Access   (Followers: 1)
ChemSystemsChem     Hybrid Journal   (Followers: 2)
ChemTexts     Hybrid Journal   (Followers: 1)
CHIMIA International Journal for Chemistry     Open Access   (Followers: 2)
Chinese Journal of Chemistry     Hybrid Journal   (Followers: 6)
Chinese Journal of Polymer Science     Hybrid Journal   (Followers: 13)
Chromatographia     Hybrid Journal   (Followers: 22)
Chromatography     Open Access   (Followers: 3)
Chromatography Research International     Open Access   (Followers: 5)
Ciencia     Open Access   (Followers: 1)
Clay Minerals     Hybrid Journal   (Followers: 9)
Cogent Chemistry     Open Access   (Followers: 3)
Colloid and Interface Science Communications     Open Access  
Colloid and Polymer Science     Hybrid Journal   (Followers: 12)
Colloids and Interfaces     Open Access  
Colloids and Surfaces B: Biointerfaces     Hybrid Journal   (Followers: 8)
Combinatorial Chemistry & High Throughput Screening     Hybrid Journal   (Followers: 4)
Combustion Science and Technology     Hybrid Journal   (Followers: 24)
Comments on Inorganic Chemistry: A Journal of Critical Discussion of the Current Literature     Hybrid Journal   (Followers: 2)

        1 2 3 4 | Last

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Canadian Association of Radiologists Journal
Journal Prestige (SJR): 0.463
Citation Impact (citeScore): 1
Number of Followers: 2  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0846-5371 - ISSN (Online) 1488-2361
Published by Sage Publications Homepage  [1166 journals]
  • Correction Notice to Canadian Medical Student’s Perception Toward
           Undergraduate Radiology Education

    • Free pre-print version: Loading...

      Abstract: Canadian Association of Radiologists Journal, Volume 72, Issue 4, Page NP1-NP1, November 2021.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-10-04T12:13:39Z
      DOI: 10.1177/08465371211051200
      Issue No: Vol. 72, No. 4 (2021)
       
  • How to Succeed in Radiology Research: A Collaboration of the CARJ and the
           CAR Resident & Fellow Section

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      Authors: Jessica L. Dobson, Matthew D. F. McInnes, Casey Hurrell, Michael Patlas
      Pages: 603 - 604
      Abstract: Canadian Association of Radiologists Journal, Volume 72, Issue 4, Page 603-604, November 2021.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-06-25T03:19:45Z
      DOI: 10.1177/08465371211025762
      Issue No: Vol. 72, No. 4 (2021)
       
  • CARJ 2021: Year in Review

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      Authors: Caitlin J. Ward, Christian B. van der Pol, Michael N. Patlas
      Pages: 710 - 713
      Abstract: Canadian Association of Radiologists Journal, Volume 72, Issue 4, Page 710-713, November 2021.
      The past year has been one of unprecedented challenge for the modern world and especially the medical profession. This review explores some of the most impactful topics published in the CARJ during the COVID-19 pandemic including physician wellbeing and burnout, patient safety, and technological innovations including dual energy CT, quantitative imaging and ultra-high frequency ultrasound. The impact of the COVID-19 pandemic on trainee education is discussed and evidence-based tips for providing value-added care are reviewed. Patient privacy considerations relevant to the development of artificial intelligence applications for medical imaging are explored. These publications in the CARJ demonstrate that although this year has brought adversity, it has also been a harbinger for new and exciting areas of focus in our field.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-04-23T05:31:28Z
      DOI: 10.1177/08465371211008428
      Issue No: Vol. 72, No. 4 (2021)
       
  • Canadian Society of Thoracic Radiology/Canadian Association of
           Radiologists Clinical Practice Guidance for Non-Vascular Thoracic MRI

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      Authors: Elsie T. Nguyen, Hamid Bayanati, Ana-Maria Bilawich, Felipe Sanchez Tijmes, Robert Lim, Scott Harris, Carole Dennie, Anastasia Oikonomou
      Pages: 831 - 845
      Abstract: Canadian Association of Radiologists Journal, Volume 72, Issue 4, Page 831-845, November 2021.
      Historically thoracic MRI has been limited by the lower proton density of lung parenchyma, cardiac and respiratory motion artifacts and long acquisition times. Recent technological advancements in MR hardware systems and improvement in MR pulse sequences have helped overcome these limitations and expand clinical opportunities for non-vascular thoracic MRI. Non-vascular thoracic MRI has been established as a problem-solving imaging modality for characterization of thymic, mediastinal, pleural chest wall and superior sulcus tumors and for detection of endometriosis. It is increasingly recognized as a powerful imaging tool for detection and characterization of lung nodules and for assessment of lung cancer staging. The lack of ionizing radiation makes thoracic MRI an invaluable imaging modality for young patients, pregnancy and for frequent serial follow-up imaging. Lack of familiarity and exposure to non-vascular thoracic MRI and lack of consistency in existing MRI protocols have called for clinical practice guidance. The purpose of this guide, which was developed by the Canadian Society of Thoracic Radiology and endorsed by the Canadian Association of Radiologists, is to familiarize radiologists, other interested clinicians and MR technologists with common and less common clinical indications for non-vascular thoracic MRI, discuss the fundamental imaging findings and focus on basic and more advanced MRI sequences tailored to specific clinical questions.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-03-30T05:44:19Z
      DOI: 10.1177/0846537121998961
      Issue No: Vol. 72, No. 4 (2021)
       
  • Atrial Strain by Feature-Tracking Cardiac Magnetic Resonance Imaging in
           Takotsubo Cardiomyopathy. Features, Feasibility, and Reproducibility

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      Authors: Riccardo Cau, Pierpaolo Bassareo, Gloria Caredda, Jasjit S. Suri, Antonio Esposito, Luca Saba
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Objectives:The purpose of this study was to investigate whether there may be a bi-atrial dysfunction in Takotsubo syndrome (TS) during the transient course of the disease, using cardiac magnetic resonance imaging feature tracking (CMR-FT) in analyzing bi-atrial strain.Method:Eighteen TS patients and 13 healthy controls were studied. Reservoir, conduit, and booster bi-atrial functions were analyzed by CMR-FT. The correlation between LA and RA strain parameters was assessed. Intra- and inter-observer reproducibility was evaluated for all strain and strain rate (SR) parameters using intraclass correlation coefficients (ICCs) and Bland-Altman analysis.Results:Atrial strain were feasible in all patients and controls. Takotsubo patients showed an impaired LA Reservoir strain (∊s), LA Reservoir strain rate (SRs), LA and RA Conduit strain(∊e), LA and RA conduit strain rate (SRe) in comparison with controls (P < 0.001 for all of them), while no differences were found as to LA and RA booster deformation parameters (∊a and SRa). Analysis of correlation showed that LA ∊s, SRs, ∊e, and SRe were positively correlated with corresponding RA strain measurements (P < 0.001, r = 0.61 and P = 0,03, r = 0,54, respectively). Reproducibility was good to excellent for all atrial strain and strain rate parameters (ICCs ranging from 0,50 to 0,96).Conclusion:Atrial strain analysis using CMR-FT may be a useful tool to reveal new pathophysiological insights in Takotsubo cardiomyopathy. Additional studies, with a larger number of patients, are needed to confirm the possible role of these advanced CMR tools in characterizing TS patients.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-10-07T08:41:59Z
      DOI: 10.1177/08465371211042497
       
  • Sociodemographic and Geographic Factors Associated With Non-Obstetrical
           Ultrasound Imaging Utilization: A Population-Based Study

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      Authors: Scott J. Adams, Shenzhen Yao, Prosanta Mondal, Hyun Lim, Ivar Mendez, Paul Babyn
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Objective:Ultrasound is one of the most commonly used imaging modalities, though some populations face barriers in accessing ultrasound services, potentially resulting in disparities in utilization. The objective of this study was to assess the association between sociodemographic and geographic factors and non-obstetrical ultrasound utilization in the province of Saskatchewan, Canada.Methods:All non-obstetrical ultrasound exams performed from 2014 to 2018 in Saskatchewan, Canada were retrospectively identified from province-wide databases. Univariate and multivariate Poisson regression analyses were performed to assess the association between ultrasound utilization and sex, age, First Nations status, Charlson Comorbidity Index, urban vs. rural residence, geographic remoteness, and neighborhood income.Results:A total of 1,324,846 individuals (5,857,044 person-years) were included in the analysis. Female sex (adjusted incidence rate ratio [aIRR], 2.20; 95% confidence interval [CI], 2.19-2.22), age (aIRR, 4.97; 95% CI, 4.90-5.05 for ≥57 years vs. 10 vs. 0; 95% CI, 3.78-5.03), and higher neighborhood income (aIRR, 1.04; 95% CI, 1.02-1.05 for highest vs. lowest quintile) were associated with higher rates of ultrasound utilization. Individuals who were status First Nations (aIRR, 0.91; 95% CI, 0.90-0.92) or resided in geographically remote areas (aIRR, 0.87 for most vs. least remote; 95% CI, 0.83-0.91) had lower rates of ultrasound utilization. Individuals who lived in a rural area also had lower rates of ultrasound utilization (aIRR, 0.93; 95% CI, 0.92-0.94).Conclusion:Substantial disparities exist in non-obstetrical ultrasound utilization among individuals in low-income neighborhoods, status First Nations individuals, and individuals in rural and remote communities.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-10-07T08:41:52Z
      DOI: 10.1177/08465371211041148
       
  • The Effect of Mask Wearing on the Accuracy of Radiology Reports in an
           Academic Hospital Setting

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      Authors: Aneta Kecler Pietrzyk, Fatma Eldehimi, Savvas Nicolaou, Shu Min Yu, Bruce B. Forster
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Background:Purpose:In response to the pandemic, some public health agencies recommend the wearing of surgical masks in indoor spaces including radiology common reporting rooms. We aim to demonstrate whether mask wearing may lead to increased errors incidence in radiology reports.Materials and Methods:Our prospective studywas conveyed in 2 parts. Firstly, the participants were surveyed if they believed that mask affected dictation. Then participants performed a dictation: they read artificial radiology reports using a commercial voice recognition (VR) system. They performed this task 5 times, each time donning a different mask in random order: a surgical mask, surgical visor, N-95, combination of 2 surgical masks and no mask. Error rates were compared with the Friedman test followed by pairwise Wilcoxon with bootstrapping. Multivariate Poisson regression was performed to test for interaction effects between potential predictors.Results:52 members of an academic radiology department participatedin the study (January – March 2021) . 65.4% of survey participants did not think or were not sure whether mask wearing could affect dictation process. Treating the no-mask condition as baseline, our study found that mean error rates significantly increased up to 2 times the baseline rate when a surgical mask, surgical visor, N-95 or a combination of 2 masks was donned (p < 0.0001). No significant differences in error rates were found between the different mask types (p > 0.05). Error rates were higher for participants with shorter VR training time (p < 0.0001) or who were non-native English speakers (p < 0.0001). There were no interaction effects between mask type, VR training time or English nativity, suggesting these variables to be independent predictors for error rate. Academic rank did not significantly affect the error rate.Conclusion:radiologists underestimate the influence of masks on dictation accuracy. mask wearing may lead to significant increase in dictational errors
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-30T01:14:02Z
      DOI: 10.1177/08465371211024394
       
  • In Memoriam: Dr. C. Stuart Houston

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      Authors: The Canadian Association of Radiologists
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-28T05:06:33Z
      DOI: 10.1177/08465371211045179
       
  • Factors Affecting Cuff Extrusion of Tunneled Hemodialysis Catheters

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      Authors: Flavius Parvulescu, Matthew J. Oliver, Myrtha E. Reyna, Robyn Pugash, Elizabeth David
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To identify patient and procedural factors associated with extrusion of the Dacron cuff from the subcutaneous tunnel of tunneled hemodialysis catheters (THDCs).Materials and methods:Single center 5-year retrospective analysis of 625 catheters in 293 adult patients. Patient data included age, gender, body mass index (BMI), and common comorbidities. Procedural details included type of procedure (new insertion vs. exchange), operator seniority, side of insertion, catheter model and presence of catheter wings skin-sutures. Complications were reported as cumulative risk over time and Cox proportional hazards model was used to evaluate risk factors for cuff extrusion (CE).Results:Median patient follow-up was 503 days (188,913 catheter-days) and median catheter survival 163 days. CE occurred in 23.8% of catheters, at a rate of 0.79 per 1,000 catheter-days and a median time of 64 days. It was more common than infection (14.6%) and inadequate flow (15.5%). The 1-month and 12-month risk of CE was 5.9% and 21.3% respectively. A first episode of CE was a strong predictor of future CE episodes. The only patient factor that affected the risk of CE was BMI (Hazard Ratio 2.36 for obese patients). Procedural factors that affected the risk of CE, adjusted for BMI, were catheter model, type of procedure (lower risk for new insertions) and catheter wings skin-sutures; the latter reduced the 30-day CE risk by 76% without increasing catheter-related infections.Conclusion:Cuff extrusion is common in long-term THDCs. The risk increases with obesity, history of previous cuff extrusion, certain catheter models and absence of wing-sutures.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-28T05:06:18Z
      DOI: 10.1177/08465371211041241
       
  • Teaching Radiology to Medical Students in Canada; a Virtual, Integrative,
           Clinical Approach

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      Authors: Serageldin Kamel, Jessica L. Dobson, Parth Patel, Aline D Khatchikian, Scott A Rohren, Jeffrey Lam Shin Cheung, Paul Rooprai, Mathew Gorman, Daniel Tomasso, Paul Greidanus, Wei Ting Xiong, Ania Kielar, Nagwa Wilson, Lawrence Stein, Mohannad Ibrahim, Hongying He, Khaled M Elsayes
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to Canadian medical students.Methods:A multidisciplinary team of radiology and other disciplines experts designed an online 5-session course that was delivered to medical students. The topics of each session were clinical cases involving different systems. The target audience was medical students of Canadian schools. Pretests and post-tests were administered before and after each session respectively. An evaluation survey was distributed at the end of the course to gauge students’ perceptions of this experience.Results:An average of 425 medical students attended the live sessions. For each session, 405 students completed both the pre-tests and post-tests. In general, students scored an average of 56% higher on the post-test than on the pre-test. The final course survey was completed by 469 students. The survey results show that more than 98% of students found the course to meet or exceed their expectations. Over 80% of students agreed that the course increased their interest in radiology and about 81% agree that the topics presented were excellent and clinically important. The ratings in the final survey results also indicate that students increased their confidence in basic radiology skills after completing the course.Conclusions:The implementation of an integrative clinical approach to teaching radiology in a virtual setting is achievable. It provides efficient use of educational resources while being accessible by a large number of students across different medical schools.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-27T11:27:58Z
      DOI: 10.1177/08465371211043562
       
  • Artificial Intelligence in Radiology: A Canadian Environmental Scan

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      Authors: David Li, Paul H. Yi
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-27T11:26:38Z
      DOI: 10.1177/08465371211038940
       
  • Injecting Hope—A Radiologist’s Experience as a Vaccination
           Lead

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      Authors: Emil J. Y. Lee
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-27T11:26:18Z
      DOI: 10.1177/08465371211036434
       
  • State of the Art Stroke Imaging: A Current Perspective

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      Authors: Rosalie McDonough, Johanna Ospel, Mayank Goyal
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Acute stroke is a widespread, debilitating disease. Fortunately, it also has one of the most effective therapeutic options available in medicine, endovascular treatment. Imaging plays a major role in the diagnosis of stroke and aids in appropriate therapy selection. Given the rapid accumulation of evidence for patient subgroups and concurrent broadening of therapeutic options and indications, it is important to recognize the benefits of certain imaging technologies for specific situations. An effective imaging protocol should: 1) be fast, 2) easily implementable, 3) produce reliable results, 4) have few contraindications, and 5) be safe, all with the goal of providing the patient the best chance of achieving a favorable outcome. In the following, we provide a review of the currently available imaging technologies, their advantages and disadvantages, as well as an overview of the future of stroke imaging. Finally, we offer a perspective.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-27T11:25:43Z
      DOI: 10.1177/08465371211028823
       
  • Digital Breast Tomosynthesis: One Step Forward

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      Authors: Anabel Medeiros Scaranelo
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-24T12:37:47Z
      DOI: 10.1177/08465371211038765
       
  • Preparation Strategies for Prostate MRI

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      Authors: Vincent M. Mellnick
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-22T10:45:44Z
      DOI: 10.1177/08465371211039215
       
  • Response to “Competency-Based Medical Education in Radiology: A Survey
           of Medical Student Perceptions”

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      Authors: Sihan Chen, Jiakun Yu, Sa-Bin Hong, Jiun Yi Hoh
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-22T10:41:50Z
      DOI: 10.1177/08465371211044832
       
  • Canadian Association of Radiologists Mammography Accreditation
           Program—Clinical Image Assessment

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      Authors: Nancy A. T. Wadden, Connie Hapgood
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      The Canadian Association of Radiologists Mammography Accreditation Program (CAR-MAP) has advocated for quality mammography since its inception in 1991. Evidence based standards have been employed to address image quality, education of personnel, radiologists experience and reading volume. This article reviews the objectives and components of the accreditation program. Education requirements for the technologist, physicist and radiologist are described. A guide to the evaluation criteria for the clinical images is provided. Positioning requirements and technical considerations are detailed to assist facilities and their personnel in improving and maintaining image quality and choosing appropriate images for submission for accreditation.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-15T08:04:56Z
      DOI: 10.1177/08465371211025195
       
  • Current Status of Contrast Enhanced Mammography: A Comprehensive Review

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      Authors: Anat Kornecki
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Objectives:The purpose of this article is to provide a detailed and updated review of the physics, techniques, indications, limitations, reporting, implementation and management of contrast enhanced mammography.Background:Contrast enhanced mammography (CEM), is an emerging iodine-based modified dual energy mammography technique. In addition to having the same advantages as standard full-field digital mammography (FFDM), CEM provides information regarding tumor enhancement, relying on tumor angiogenesis, similar to dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). This article reviews current literature on CEM and highlights considerations that are critical to the successful use of this modality.Conclusion:Multiple studies point to the advantage of using CEM in the diagnostic setting of breast imaging, which approaches that of DCE-MRI.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-07T10:19:04Z
      DOI: 10.1177/08465371211029047
       
  • Breast Mammographic Screening: The More Mammograms Read, the Better the
           Performance

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      Authors: Mona El Khoury, Mesurolle Benoit
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-06T04:33:32Z
      DOI: 10.1177/08465371211040699
       
  • Reducing Motion Artifacts in Pelvic Oncologic Magnetic Resonance Imaging:
           The Quest for the Free Lunch

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      Authors: Iain D. C. Kirkpatrick
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-06T04:31:12Z
      DOI: 10.1177/08465371211039193
       
  • Diagnostic Errors in Emergency Neuroradiology: Can We Do Better'

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      Authors: Fateme Salehi, Khunsa Faiz, Michael N. Patlas
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-06T04:30:32Z
      DOI: 10.1177/08465371211039177
       
  • Breast Density and Risk of Interval Cancers

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      Authors: Paula B. Gordon
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-09-06T04:26:57Z
      DOI: 10.1177/08465371211030573
       
  • Analyzing the Administrative Burden of Competency Based Medical Education

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      Authors: Kevin Cheung, Christina Rogoza, Andrew D. Chung, Benjamin Yin Ming Kwan
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) system. Within this system, resident performance is documented through frequent assessments that provide continual feedback and guidance for resident progression. An area of concern is the perception by faculty of added administrative burden imposed by the frequent evaluations. This study investigated the time spent in the documentation and submission of required assessment forms through analysis of quantitative data from the Queen’s University Diagnostic Radiology program.Methods and Materials:Data regarding time taken to complete Entrustable Professional Activities (EPA) assessments was collected from 24 full-time and part-time radiologists over a period of 18 months. This data was analyzed using SPSS to determine mean time of completion by individuals, departments, and by experience with the assessment process.Results:The average time taken to complete an EPA assessment form was 3 minutes and 6 seconds. Assuming 3 completed EPA assessment forms per week for each resident (n = 12) and equal distribution among all staff, this averaged out to an additional 18 minutes of administrative burden per staff member over a 4 week block.Conclusions:This study investigated the perception by faculty of additional administrative burden for assessment in the CBME framework. The data provided quantitative evidence of administrative burden for the documentation and submission of assessments. The data indicated that the added administrative burden may be reasonable given mandate for CBME implementation and the advantages of adoption for postgraduate medical education.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-27T06:02:20Z
      DOI: 10.1177/08465371211038963
       
  • What Is the Minimum' A Survey in Procedural Competency in Diagnostic
           Radiology in the Era of Competency Based Medical Education

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      Authors: Arsalan P. Rizwan, Nicholas Cofie, Benedetto Mussari, Andrew D. Chung, Benjamin Y. M. Kwan
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-24T10:49:42Z
      DOI: 10.1177/08465371211040262
       
  • The Power of Diffusion-Weighted Images and ADC Maps in Breast MRI

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      Authors: Amr Elnayal, Ameya Kulkarni, Abdullah Alabousi, Amer Alaref
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-23T09:03:05Z
      DOI: 10.1177/08465371211022289
       
  • The Impact of Radiologist Screening Mammogram Reading Volume on
           Performance in the Ontario Breast Screening Program

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      Authors: Meghan J. Walker, Krystal Hartman, Vicky Majpruz, Yvonne W. Leung, Samantha Fienberg, Linda Rabeneck, Anna M. Chiarelli
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Although some studies have shown increasing radiologists’ mammography volumes improves performance, there is a lack of evidence specific to digital mammography and breast screening program performance targets. This study evaluates the relationship between digital screening volume and meeting performance targets.Methods:This retrospective cohort study included 493 radiologists in the Ontario Breast Screening Program who interpreted 1,762,173 screening mammograms in participants ages 50-90 between 2014 and 2016. Associations between annual screening volume and meeting performance targets for abnormal call rate, positive predictive value (PPV), invasive cancer detection rate (CDR), sensitivity, and specificity were modeled using mixed-effects multivariate logistic regression.Results:Most radiologists read 500-999 (36.7%) or 1,000-1,999 (31.0%) screens annually, and 18.5% read ≥2,000. Radiologists who read ≥2,000 annually were more likely to meet abnormal call rate (OR = 3.85; 95% CI: 1.17-12.61), PPV (OR = 5.36; 95% CI: 2.53-11.34), invasive CDR (OR = 4.14; 95% CI: 1.50-11.46), and specificity (OR = 4.07; 95% CI: 1.89-8.79) targets versus those who read 100-499 screens. Radiologists reading 1,000-1,999 screens annually were more likely to meet PPV (OR = 2.32; 95% CI: 1.22-4.40), invasive CDR (OR = 3.36; 95% CI: 1.49-7.59) and specificity (OR = 2.00; 95% CI: 1.04-3.84) targets versus those who read 100-499 screens. No significant differences were observed for sensitivity.Conclusions:Annual reading volume requirements of 1,000 in Canada are supported as screening volume above 1,000 was strongly associated with achieving performance targets for nearly all measures. Increasing the minimum volume to 2,000 may further reduce the potential limitations of screening due to false positives, leading to improvements in overall breast screening program quality.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-23T06:16:36Z
      DOI: 10.1177/08465371211031186
       
  • T2-PROPELLER Compared to T2-FRFSE for Image Quality and Lesion Detection
           at Prostate MRI

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      Authors: Dorota Czyzewska, Nikita Sushentsev, Eryk Latoch, Rhys A. Slough, Tristan Barrett
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:The primary objective was to compare T2-FRFSE and T2-PROPELLER sequences for image quality. The secondary objective was to compare the ability to detect prostate lesions at MRI in the presence and absence of motion artefact using the 2 sequences.Methods:99 patients underwent 3 T MRI examination of the prostate, including T2-FRFSE and T2-PROPELLER sequences. All patients underwent prostate biopsy. Two independent readers rated overall image quality, presence of motion artefact, and blurring for both sequences using a 5-point Likert scale. Scores were compared for the whole group and for subgroups with and without significant motion artefact. Outcome for lesion detection at an MRI threshold of PI-RADS score ≥3 was compared between T2-FRFSE and T2-PROPELLER.Results:The overall image quality was not significantly different between T2-FRFSE and T2-PROPELLER sequences (3.74 vs. 3.93, p = 0.275). T2-PROPELLER recorded a lesser degree of motion artefact (score 4.53 vs. 3.78, p
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-23T05:34:18Z
      DOI: 10.1177/08465371211030206
       
  • Comparison of 5 Rectal Preparation Strategies for Prostate MRI and Impact
           on Image Quality

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      Authors: Paul Sathiadoss, Mohammad Haroon, Heba Osman, Faraz Ahmad, Philip Papadatos, Nicola Schieda
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To compare 5 different rectal preparation strategies for prostate MRI.Methods:This 5-arm quality-assurance study evaluated 56 patients per arm (280 patients) including: no preparation, clear-fluids diet (CFD) beginning at 00:00 hours on the day of MRI, Fleet®-enema, enema + CFD, enema + CFD + IV-antispasmodic agent. The study was powered to 0.80 with alpha-error of 0.05. Three blinded radiologists independently evaluated T2-Weighted (T2W) and Diffusion Weighed Imaging (DWI) for: rectal diameter (maximal AP diameter), rectal content (stool, fluid, gas), rectal motion, T2W/DWI image quality, T2W image sharpness and DWI susceptibility artifact using 5-point Likert scales. Overall comparisons were performed using analysis of variance (ANOVA) and Kruskal-Wallis, with pair-wise comparisons using paired t-tests and Wilcoxon sign-rank tests.Results:Rectal diameter and amount of gas were lower in enema compared to non-enema groups (p < 0.001), with smallest diameter and least gas in the enema + CFD + IV-antispasmodic group (p = 0.022-
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-18T05:03:46Z
      DOI: 10.1177/08465371211033753
       
  • Reproducibility of MRI Features of Uterine Leiomyomas: A Study on
           Interobserver Agreement and Inter-Method Agreement With Surgery

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      Authors: Guilherme Castilho Sorensen de Lima, Ulysses S. Torres, Leticia Ferreira Bueno, Gustavo Pedreira Rodi, Larissa Rossini Favaro, Glaucy Lane Neme, Ricardo Mendes Alves Pereira, Leandro Accardo de Mattos, Giuseppe D’Ippolito
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To evaluate interobserver agreement in the interpretation of different MRI features of uterine leiomyomas (UL) according to observers’ experience, and to assess the inter-method reproducibility (MRI versus surgery) regarding the International Federation of Gynecology and Obstetrics (FIGO) classification.Methods:Retrospective study including UL patients who underwent MRI and surgical treatment. Four blinded observers (2 vs >10 years of experience) assessed UL regarding dimensions and volume; inner and outer mantles; FIGO classification; vascularization; degeneration; and diffusion-weighted imaging features. Uterine dimensions and volume were calculated. FIGO classification as ascertained by observers was compared to surgical findings. Intraclass correlation coefficient (ICC) estimates were used for interobserver comparison of numerical variables, and kappa statistic for categorical variables.Results:Thirty-five patients (26y-73y) with 61 UL were included in the interobserver analyses, and 31 patients (54 UL) had available data allowing retrospective surgical FIGO classification for assessment of inter-method reproducibility. Both groups of observers had good to excellent agreement in assessing UL (ICC = 0.980-0.994) and uterine volumes (ICC = 0.857-0.914), mantles measurement (ICC = 0.797-0.920), and apparent diffusion coefficient calculation (ICC = 0.787-0.883). There was substantial agreement for both groups regarding FIGO classification (κ = 0.645-0.767). Vascularization, degeneration and restricted diffusion had lower agreement, varying from reasonable to moderate. Inter-method agreement was reasonable (κ = 0.341-0.395).Conclusions:Interobserver agreement of MRI for UL was higher for quantitative than qualitative features, with a little impact of observers’ experience for most features. MRI agreement with surgery was reasonable. Further efforts should be taken to improve interobserver and inter-method reproducibility for MRI in this scenario.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-16T11:10:26Z
      DOI: 10.1177/08465371211038546
       
  • Addressing Radiology Burnout During the COVID-19 Pandemic

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      Authors: Nanxi Zha
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-16T11:04:01Z
      DOI: 10.1177/08465371211036971
       
  • What’s Hot in Breast MRI

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      Authors: Anabel M. Scaranelo
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Several articles in the literature have demonstrated a promising role for breast MRI techniques that are more economic in total exam time than others when used as supplement to mammography for detection and diagnosis of breast cancer. There are many technical factors that must be considered in the shortened breast MRI protocols to cut down time of standard ones, including using optimal fat suppression, gadolinium-chelates intravascular contrast administrations for dynamic imaging with post processing subtractions and maximum intensity projections (MIP) high spatial and temporal resolution among others. Multiparametric breast MRI that includes both gadolinium-dependent, i.e., dynamic contrast-enhanced (DCE-MRI) and gadolinium-free techniques, i.e., diffusion-weighted/diffusion-tensor magnetic resonance imaging (DWI/DTI) are shown by several investigators that can provide extremely high sensitivity and specificity for detection of breast cancer. This article provides an overview of the proven indications for breast MRI including breast cancer screening for higher than average risk, determining chemotherapy induced tumor response, detecting residual tumor after incomplete surgical excision, detecting occult cancer in patients presenting with axillary node metastasis, detecting residual tumor after incomplete breast cancer surgical excision, detecting cancer when results of conventional imaging are equivocal, as well patients suspicious of having breast implant rupture. Despite having the highest sensitivity for breast cancer detection, there are pitfalls, however, secondary to false positive and false negative contrast enhancement and contrast-free MRI techniques. Awareness of the strengths and limitations of different approaches to obtain state of the art MR images of the breast will facilitate the work-up of patients with suspicious breast lesions.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-12T10:41:03Z
      DOI: 10.1177/08465371211030944
       
  • Limited Chest Ultrasound to Replace CXR in Diagnosis of Pneumothorax Post
           Image-Guided Transthoracic Interventions

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      Authors: Hooman Hosseini-Nik, Hamid Bayanati, Carolina A. Souza, Ashish Gupta, Matthew D. F. McInnes, Elena Pena, Giselle Revah, Jean M. Seely, Carole Dennie
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To assess the diagnostic accuracy of limited chest ultrasound in detecting pneumothorax following percutaneous transthoracic needle interventions using chest X-ray (CXR) as the reference standard.Methods:With IRB approval, after providing consent, asymptomatic patients after percutaneous transthoracic needle interventions were enrolled to undergo limited chest ultrasound in addition to CXR. A chest Radiologist blinded to the patient’s prior imaging performed a bedside ultrasound, scanning only the first 3 anterior intercostal spaces. Pneumothorax diagnosed on CXR was categorized as small or large and on ultrasound as grades 1, 2, or 3 when detected in 1, 2, or 3 intercostal spaces, respectively.Results:38 patients underwent 36 biopsies (34 lungs, 1 pleura, and 1 mediastinum) and 2 coil localizations. CXR showed pneumothorax in 13 patients. Ultrasound was positive in 10 patients, with 9 true-positives, 1 false-positive, 4 false-negatives, and 24 true-negatives. The false positive results were due to apical subpleural bullae. The false-negative results occurred in 2 small apical and 2 focal pneumothoraces at the needle entry sites. Four pneumothoraces were categorized as large on CXR, all of which were categorized as grade 3 on ultrasound. Sensitivity and specificity of US for detection of pneumothorax of any size were 69.23% (95%CI 38.6%, 90.1%) and 96.0% (95%CI 79.6%, 99.9%), and for detection of large pneumothorax were 100% (95%CI 39.8%, 100%) and 100% (95%CI 89.7%, 100%).Conclusions:Results of this prospective study is promising. Limited chest ultrasound could potentially replace CXR in the management of postpercutaneous transthoracic needle intervention patients.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-10T10:05:09Z
      DOI: 10.1177/08465371211034016
       
  • Canadian Medical Student’s Perception Toward Undergraduate Radiology
           Education

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      Authors: Scott A. Rohren, Parth Patel, Jessica L. Dobson, Aline D. Khatchikian, Serageldin Kamel, Kathleen M. MacMillan, Raza Syed, Ania Kielar, Shaylin Pillay, Rogers S. Patrick, Erin E. Baker, Ibrahim M. Nadeem, Nagwa Wilson, Lawrence A. Stein, Khaled M. Elsayes
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-05T09:47:19Z
      DOI: 10.1177/08465371211035113
       
  • Breast Biopsy Marker: Is Bigger Better'

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      Authors: El Khoury Mona, Sanchez Lilia Maria, Mesurolle Benoit
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-08-05T09:45:46Z
      DOI: 10.1177/08465371211034400
       
  • Ultra-High Field 7-Tesla Magnetic Resonance Imaging and
           Electroencephalography Findings in Epilepsy

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      Authors: Fateme Salehi, Ibrahim M. Nadeem, Benjamin Y. M. Kwan, Seyed M. Mirsattari, Donald H. Lee, Jorge G. Burneo, David Steven, Robert Hammond, Terry M. Peters, Ali R. Khan
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Assessment of patients for temporal lobe epilepsy (TLE) surgery requires multimodality input, including EEG recordings to ensure optimal surgical planning. Often EEG demonstrates abnormal foci not detected on 1.5T MRI. Ultra-high field MRI at 7T provides improved resolution of the brain. We investigated the utility of 7T MRI to detect potential anatomical abnormalities associated with EEG changes.Methods:Ultra-high field data were acquired on a 7T MRI scanner for 13 patients with history of drug resistant TLE who had had EEG telemetry recordings. Qualitative evaluation of 7T imaging for presence of focal abnormalities detected on EEG was performed. Correlation of 7T MRI findings with EEG recordings of focal slowing or interictal epileptic spikes (IEDs), and seizures was performed.Results:Assessment of 7T MRI demonstrated concordance with TLE as determined by the multidisciplinary team in 61.5% of cases (n = 8). Among these, 3 patients exhibited supportive abnormal 7T MRI abnormalities not detected by 1.5T MRI. In patients who underwent surgery, 72.7% had concordant histopathology findings with 7T MRI findings (n = 8). However, qualitative assessment of 7T images revealed focal anatomical abnormalities to account for EEG findings in only 15.4% of patients (n = 2). Other regions that were found to have localized IEDs in addition to the lesional temporal lobe, included the contralateral temporal lobe (n = 5), frontal lobe (n = 3), and parieto-occipital lobe (n = 2).Conclusion:Ultra-high field 7T MRI findings show concordance with clinical data. However, 7T MRI did not reveal anatomical findings to account for abnormalities detected by EEG.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-30T09:50:41Z
      DOI: 10.1177/08465371211031802
       
  • Perspectives on the Evolution of Diagnosis and Management of Acute
           Pulmonary Embolism

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      Authors: Constantine A Raptis, Kacie L Steinbrecher, Kaitlin M Marquis
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-27T07:39:31Z
      DOI: 10.1177/08465371211026530
       
  • Correction to: The Canadian Society of Breast Imaging/Canadian Association
           of Radiologists’ Recommendations for the Management of Axillary
           Adenopathy in Patients With Recent COVID-19 Vaccination

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      Authors: Jean M. Seely
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-27T05:28:59Z
      DOI: 10.1177/08465371211029086
       
  • Wouldn’t Have Happened in My Day……

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      Authors: Adrian P Brady
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-27T02:56:18Z
      DOI: 10.1177/08465371211031395
       
  • Magnetic Resonance Cholangiopancreatography (MRCP) in the Setting of Acute
           Pancreaticobiliary Disease: Can Certain Clinical Factors Guide Appropriate
           Utilization'

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      Authors: Stuart Breakey, Alison C. Harris
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-27T02:38:51Z
      DOI: 10.1177/08465371211025527
       
  • Incidental Pancreatic Findings: When to Follow Up'

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      Authors: Michael N. Patlas
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-27T02:37:43Z
      DOI: 10.1177/08465371211031189
       
  • Prospective Clinical Trial Comparing IV Esmolol to IV Metoprolol in CT
           Coronary Angiography: Effect on Hemodynamic, Technical Parameters and Cost
           

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      Authors: Leena Robinson Vimala, Diego Andre Eifer, Yasser Karimzad, Narinder S. Paul
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Background:Intravenous [IV] esmolol, an alternative to IV metoprolol for coronary computed tomography angiography [CCTA], has shorter half-life that decreases the risk of prolonged hypotension. The primary aim was to prospectively compare IV esmolol alone to IV metoprolol alone for effectiveness in achieving heart rate [HR] of 60 beats per minute[bpm] during CCTA. The secondary aim was to compare hemodynamic response, image quality, radiation dose and cost.Materials and Methods:Institutional Review Board approved prospective randomized study of 28 CCTA patients medicated in a 1:1 blinded match with IV esmolol or IV metoprolol to achieve HR of 60 bpm. Serial hemodynamic response was measured at 6 specified times. Two cardiac radiologists independently scored the image quality.Results:Both IV esmolol and IV metoprolol achieved the target HR. IV esmolol resulted in significantly less profound and shorter duration of reduction in systolic blood pressure [BP] than IV metoprolol with a difference of -10, -14 and -9 mm Hg compared to -20, -26 and -25 mmHg at 2, 15 & 30 min respectively. No significant difference in HR at image acquisition, exposure window, radiation dose and image quality. Although IV esmolol was expensive, the overall cost of care was comparable to IV metoprolol due to shortened post CCTA observation period consequent to faster restoration of hemodynamic status.Conclusion:Comparison of IV esmolol and IV metoprolol demonstrate that both are effective in achieving the target HR but significantly faster recovery of HR and BP in patients who receive IV esmolol was found.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-23T03:50:35Z
      DOI: 10.1177/08465371211023947
       
  • Breast Density and Risk of Interval Cancers: The Effect of Annual Versus
           Biennial Screening Mammography Policies in Canada

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      Authors: Jean Morag Seely, Susan Elizabeth Peddle, Huiming Yang, Anna M. Chiarelli, Megan McCallum, Gopinath Narasimhan, Dianne Zakaria, Craig C. Earle, Sharon Fung, Heather Bryant, Erika Nicholson, Chris Politis, Wendie A. Berg
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Regular screening mammography reduces breast cancer mortality. However, in women with dense breasts, the performance of screening mammography is reduced, which is reflected in higher interval cancer rates (ICR). In Canada, population-based screening mammography programs generally screen women biennially; however, some provinces and territories offer annual mammography for women with dense breast tissue routinely and/or on recommendation of the radiologist. This study compared the ICRs in those breast screening programs with a policy of annual vs. those with biennial screening for women with dense breasts. Among 148,575 women with dense breasts screened between 2008 to 2010, there were 288 invasive interval breast cancers; screening programs with policies offering annual screening for women with dense breasts had fewer interval cancers 63/70,814 (ICR 0.89/1000, 95% CI: 0.67-1.11) compared with those with policies of usual biennial screening 225/77,761 (ICR 1.45 /1000 (annualized), 95% CI: 1.19-1.72) i.e. 63% higher (p = 0.0016). In screening programs where radiologists’ screening recommendations were able to be analyzed, a total of 76,103 women were screened, with 87 interval cancers; the ICR was lower for recommended annual (65/69,650, ICR 0.93/1000, 95% CI: 0.71, 1.16) versus recommended biennial screening (22/6,453, ICR 1.70/1000 (annualized), 95%CI: 0.70, 2.71)(p = 0.0605). Screening program policies of annual as compared with biennial screening in women with dense breasts had the greatest impact on reducing interval cancer rates. We review our results in the context of current dense breast notification in Canada.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-19T01:56:22Z
      DOI: 10.1177/08465371211027958
       
  • Impact of 24/7 Onsite Emergency Radiology Staff Coverage on Emergency
           Department Workflow

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      Authors: Francesco Macri, Bonnie T. Niu, Shannon Erdelyi, John R. Mayo, Faisal Khosa, Savvas Nicolaou, Jeffrey R. Brubacher
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Assess the impact of 24/7/365 emergency trauma radiology (ETR) coverage on Emergency Department (ED) patient flow in an urban, quaternary-care teaching hospital.Methods:Patient ED visit and imaging information were extracted from the hospital patient care information system for 2008 to 2018. An interrupted time-series approach with a comparison group was used to study the impact of 24/7/365 ETR on average monthly ED length of stay (ED-LOS) and Emergency Physician to disposition time (EP-DISP). Linear regression models were fit with abrupt and permanent interrupts for 24/7/365 ETR, a coefficient for comparison series and a SARIMA error term; subgroup analyses were performed by patient arrival time, imaging type and chief complaint.Results:During the study period, there were 949,029 ED visits and 739,796 diagnostic tests. Following implementation of 24/7/365 coverage, we found a significant decrease in EP-DISP time for patients requiring only radiographs (-29 min;95%CI:-52,-6) and a significant increase in EP-DISP time for major trauma patients (46 min;95%CI:13,79). No significant change in patient throughput was observed during evening hours for any patient subgroup. For overnight patients, there was a reduction in EP-DISP for patients with symptoms consistent with stroke (-78 min;95%CI:-131,-24) and for high acuity patients who required imaging (-33 min;95%CI:-57,-10). Changes in ED-LOS followed a similar pattern.Conclusions:At our institution, 24/7/365 in-house ETR staff radiology coverage was associated with improved ED flow for patients requiring only radiographs and for overnight stroke and high acuity patients. Major trauma patients spent more time in the ED, perhaps reflecting the required multidisciplinary management.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-07T05:41:03Z
      DOI: 10.1177/08465371211023861
       
  • Digital Breast Tomosynthesis: Potential Benefits in Routine Clinical
           Practice

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      Authors: Supriya Kulkarni, Vivianne Freitas, Derek Muradali
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Digital breast tomosynthesis (DBT) is gradually being implemented in routine clinical breast imaging practice. The technique of image acquisition reduces the confounding effect of overlapping breast tissue, which substantially affects cancer detection, abnormal recall, and interval cancer rates in a screening/ surveillance setting. In a diagnostic setting, tomosynthesis also allows for improved lesion localization and characterization over conventional imaging, which potentially improves the accuracy and improved workflow efficiency. To optimize the utility of tomosynthesis, imagers should be aware of the pertinent aspects of image acquisition as it relates to interpretation, the appearance of benign and malignant pathologies, and sources of possible misinterpretation. This article aims to provide a practical knowledge base of DBT and demonstrate its potential benefits when incorporated into routine clinical practice.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-07T03:45:26Z
      DOI: 10.1177/08465371211025229
       
  • Is Call Karma Real' Resident After-Hours On-Call Imaging at the
           University of Saskatchewan: An Assessment of Call Volumes Including
           Inter-Resident Variability

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      Authors: James Huynh, David Horne, Rhonda Bryce, David A Leswick
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Quantify resident caseload during call and determine if there are consistent differences in call volumes for individuals or resident subgroups.Methods:Accession codes for after-hours computed tomography (CT) cases dictated by residents between July 1, 2012 and January 9, 2017 were reviewed. Case volumes by patient visits and body regions scanned were determined and categorized according to time period, year, and individual resident. Mean shift Relative Value Units (RVUs) were calculated by year. Descriptive statistics, linear mixed modeling, and linear regression determined mean values, differences between residents, associations between independent variables and outcomes, and changes over time. Consistent differences between residents were assessed as a measure of good or bad luck / karma on call.Results:During this time there were 23,032 patients and 30,766 anatomic regions scanned during 1,652 call shifts among 32 residents. Over the whole period, there were on average 10.6 patients and 14.3 body regions scanned on weekday shifts and 22.3 patients and 29.4 body regions scanned during weekend shifts. Annually, the mean number of patients, body regions, and RVUs scanned per shift increased by an average of 0.2 (1%), 0.4 (2%), and 1.2 (5%) (all p < 0.05) respectively in regression models. There was variability in call experiences, but only 1 resident had a disproportionate number of higher volume calls and fewer lower volume shifts than expected.Conclusions:Annual increases in scan volumes were modest. Although residents’ experiences varied, little of this was attributable to consistent personal differences, including luck or call karma.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-06T09:26:45Z
      DOI: 10.1177/08465371211026310
       
  • Diagnostic Errors in Neuroradiology: A Message to Emergency Radiologists
           and Trainees

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      Authors: Abdelmohsen Radwan Hussien, Waleed Abdellatif, Zaid Siddique, Kavya Mirchia, Monaliza El-Quadi, Ali Hussain
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Diagnostic errors in neuroradiology are inevitable, yet potentially avoidable. Through extensive literature search, we present an up-to-date review of the psychology of human decision making and how such complex process can lead to radiologic errors. Our focus is on neuroradiology, so we augmented our review with multiple explanatory figures to show how different errors can reflect on real-life clinical practice. We propose a new thematic categorization of perceptual and cognitive biases in this article to simplify message delivery to our target audience: emergency/general radiologists and trainees. Additionally, we highlight individual and organizational remedy strategies to decrease error rate and potential harm.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-06T09:26:14Z
      DOI: 10.1177/08465371211025738
       
  • Imaging, Paternalism and the Worried Patient: Rethinking Our Approach

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      Authors: Shushiela Appavoo
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      The Covid pandemic has taught many lessons, including the importance of mental health. The value of the radiologist in holistic patient care may be underestimated and underresearched. Barriers to the acceptance of imaging as an important component in reassurance may be rooted in old ideas minimizing the importance of mental health.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-07-06T09:05:19Z
      DOI: 10.1177/08465371211021996
       
  • Canada Safe Imaging: Promoting Radiation Safety in Healthcare Institutions

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      Authors: David Koff, Sandor Demeter, Jane Castelli
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-06-25T03:10:22Z
      DOI: 10.1177/08465371211024921
       
  • Evaluation of the Modified Barium Swallow Study Conducted With and Without
           Radiologist Supervision: A Pre- and Post-Observational Study

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      Authors: Luhe Yang, David Leswick, Michael Butler, Tasha Ellchuk
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Assess quality metrics of modified barium swallow studies (MBSS) with and without a radiologist present during the procedure.Methods:Retrospective review of MBSS performed on adult inpatients at a tertiary care hospital 6-months pre- and post-institutional change from having to not having a radiologist present during the examination.Factors assessed included:fluoroscopy time; study duration; number of cine loops; number of images; efficiency of collimation (using a 5-point scoring system); time to final report; radiologist-speech language pathologist report disagreement; and recalls for inadequate studies. Statistical analysis was via Welch’s t-test and a test of proportions for continuous and count data under the normal approximation.Results:106 and 119 MBSS were analyzed from the radiologist present and radiologist absent periods, respectively. No statistically significant differences were found for: average fluoroscopy time (116.1 s vs. 126.9 s; P = 0.161); study duration (400.4 s vs. 417.3 s; P = 0.453); number of cine loops (9.3 vs. 10.2; P = 0.075); number of images (620.5 vs. 581.1; P = 0.350); or report disagreement. There was improved performance without the radiologist present for collimation (1.92 vs. 1.43; P = 0.003) and fewer non-diagnostic images (6.5 vs. 4.5; P = 0.001). Time to final report was longer with the radiologist absent due to more reports with significant delays. There were no repeated studies because of inadequate technique in either group.Conclusion:MBSS performed by technologists without radiologist supervision is not inferior to those performed with radiologist supervision on multiple performance measures. This supports technologist operated MBSS without radiologist supervision, while acknowledging a need to further address radiologist report time delay.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-06-23T11:59:31Z
      DOI: 10.1177/08465371211020630
       
  • Recommendations for the Management of Incidental Pancreatic Findings in
           Adults by the Canadian Association of Radiologists Incidental Findings
           Working Group

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      Authors: Christopher I. Fung, David L. Bigam, Clarence K. W. Wong, Casey Hurrell, Jeffery R. Bird, Gary L. Brahm, Iain D. C. Kirkpatrick
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      The Canadian Association of Radiologists Incidental Findings Working Group consists of both academic subspecialty and general radiologists and is tasked with adapting and expanding upon the American College of Radiology incidental findings white papers to more closely apply to Canadian practice patterns, particularly more comprehensively dealing with the role of ultrasound and pursuing more cost-effective approaches to the workup of incidental findings without compromising patient care. Presented here are the 2021 Canadian guidelines for the management of pancreatic incidental findings. Topics covered include anatomic variants, fatty atrophy, pancreatic calcifications, ductal ectasia, and management of incidental pancreatic cysts.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-06-22T05:30:43Z
      DOI: 10.1177/08465371211021079
       
  • Imaging for Predicting Hemorrhagic Transformation of Acute Ischemic
           Stroke—A Narrative Review

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      Authors: Sudharsana Rao Ande, Jonathan Grynspan, Richard I. Aviv, Jai Jai Shiva Shankar
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Hemorrhagic transformation is caused by extravasation of blood products from vessels after acute ischemic stroke. It is an undesirable and potentially devastating complication, which occurs in 10%-40% of clinical cases. Hemorrhagic transformation is classified into four subtypes based on European cooperative acute stroke study II. Predicting hemorrhagic complications at presentation can be useful life saving/altering decisions for the patient. Also, understanding the mechanisms of hemorrhagic transformation can lead to new treatments and intervention measures. We highlighted various imaging techniques that have been used to predict hemorrhagic transformation. Specifically, we looked at the usefulness of perfusion and permeability imaging for hemorrhagic transformation. Use of imaging to predict hemorrhagic transformation could change patient management that may lead to the prevention of hemorrhagic transformation before it occurs. We concluded that the current evidence is not strong enough to rely on these imaging parameters for predicting hemorrhagic transformation and more studies are required.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-06-22T05:27:47Z
      DOI: 10.1177/08465371211018369
       
  • Burnout Exacerbation due to COVID-19 Pandemic

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      Authors: Amer Alaref, Amr Elnayal, Ameya Kulkarni, Abdullah Alabousi, Christian Van Der Pol
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-06-18T05:25:09Z
      DOI: 10.1177/08465371211022291
       
  • The Added Value of Supplemental Breast Ultrasound Screening for Women With
           Dense Breasts: A Single Center Canadian Experience

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      Authors: Tong Wu, Linda J. Warren
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:We evaluated the contribution to cancer detection of supplemental breast ultrasound screening in women with dense breasts based on a single center experience by comparing our results with similar programs elsewhere.Methods:We performed a retrospective review of handheld sonographer-performed screening ultrasound exams at our academic breast imaging center, from January 1st to December 31st, 2019. Breast density, breast cancer risk factors, BI-RADS assessment, and lesion pathology were reviewed and tallied, followed by derivation of the biopsy rate, breast cancer detection rate, PPV3 and average tumor size. These values were compared to published results of breast screening programs elsewhere.Results:695 screening breast ultrasounds for women with dense breasts and negative mammograms were performed in 2019. The biopsy rate was 1.3%, breast cancer detection rate was 7 in 1000, PPV3 was 42%, and the average tumor size was 9.0 ± 1.4 mm.Conclusions:The first-year data of the breast screening ultrasound program at our practice are promising, demonstrating comparable cancer detection rate, higher PPV3, and similar biopsy rate in those with dense breasts compared with similar programs elsewhere. Longitudinal analysis and larger sample size are required for validation. Comparison of incidence and prevalence screening data is also warranted to elucidate the true value of this program.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-06-17T05:12:09Z
      DOI: 10.1177/08465371211011707
       
  • Does Immobilization Post Injection Reduce Contrast Extravasation in MR
           Arthrography of the Shoulder'

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      Authors: Adrian Marcuzzi, Bruce B. Forster
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-06-11T12:30:25Z
      DOI: 10.1177/08465371211023889
       
  • Reply to “Arteries of the Lower Limb—Embryology, Variations, and
           Clinical Significance”

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      Authors: Riccardo Cau, Luca Saba
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-05-24T08:50:55Z
      DOI: 10.1177/08465371211020011
       
  • The Diagnostic Yield of Magnetic Resonance Cholangiopancreatography in the
           Setting of Acute Pancreaticobiliary Disease — A Single Center Experience
           

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      Authors: Sultan Yahya, Abdullah Alabousi, Peri Abdullah, Milita Ramonas
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To discern whether preceding ultrasound (US) results, patient demographics and biochemical markers can be implemented as predictors of an abnormal Magnetic Resonance Cholangiopancreatography (MRCP) study in the context of acute pancreaticobiliary disease.Methods:A retrospective study was performed assessing US results, age, gender, elevated lipase and biliary enzymes for consecutive patients who underwent an urgent MRCP following an initial US for acute pancreaticobiliary disease between January 2017-December 2018. Multivariable binary logistic regression models were constructed to assess for predictors of clinically significant MRCPs, and discrepant US/MRCP results.Results:A total of 155 patients (mean age 56, 111 females) were included. Age (OR 1.03, P < 0.05), hyperlipasemia (OR 5.33, P < 0.05) and a positive US (OR 40.75, P < 0.05) were found to be independent predictors for a subsequent abnormal MRCP. Contrarily, gender and elevated biliary enzymes were not reliable predictors of an abnormal MRCP, or significant MRCP/US discrepancies. Of 66 cases (43%) of discordant US/MRCPs, half had clinically significant discrepant findings such as newly discovered choledocholithiasis and pancreaticobiliary neoplasia. Age was the sole predictor for a significant US/MRCP discrepancy, with 2% increase in the odds of a significant discrepancy per year of increase in age.Conclusion:An abnormal US, hyperlipasemia and increased age serve as predictors for a subsequent abnormal MRCP, as opposed to gender and biliary enzyme elevation. Age was the sole predictor of a significant US/MRCP discrepancy that provided new information which significantly impacted subsequent management. In the remaining cases, however, MRCP proved useful in reaffirming the clinical diagnosis and avoiding further investigations.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-05-24T08:24:55Z
      DOI: 10.1177/08465371211013786
       
  • Canadian Association of Radiologists Recommendations for the Safe Use of
           MRI During Pregnancy

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      Authors: Pejman Jabehdar Maralani, Anish Kapadia, Grace Liu, Felipe Moretti, Hournaz Ghandehari, Sharon E. Clarke, Sheldon Wiebe, Juliette Garel, Birgit Ertl-Wagner, Casey Hurrell, Nicola Schieda
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      The use of magnetic resonance imaging (MRI) during pregnancy is associated with concerns among patients and health professionals with regards to fetal safety. In this work, the Canadian Association of Radiologists (CAR) Working Group on MRI in Pregnancy presents recommendations for the use of MRI in pregnancy, derived from literature review as well as expert panel opinions and discussions. The working group, which consists of academic subspecialty radiologists and obstetrician-gynaecologists, aimed to provide updated, evidence-based recommendations addressing safety domains related to energy deposition, acoustic noise, and gadolinium-based contrast agent use based on magnetic field strength (1.5T and 3T) and trimester scanned, in addition to the effects of sedative use and occupational exposure.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-05-18T06:47:25Z
      DOI: 10.1177/08465371211015657
       
  • Qualitative Assessment of Advanced MRI in Post-Treatment High Grade
           Gliomas Follow Up: Do We Agree'

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      Authors: Nader Zakhari, Michael Taccone, Carlos Torres, Santanu Chakraborty, John Sinclair, John Woulfe, Gerard Jansen, Greg Cron, Thanh B. Nguyen
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:MRI is commonly used in follow up of high grade glioma. Our purpose is to assess the interrater agreement on the increasingly used visual qualitative assessment of various conventional and advanced MR techniques in the setting of treated high grade glioma in comparison to the well established quantitative measurements.Methods:We prospectively enrolled HGG patients who underwent reresection of a new enhancing lesion on post-treatment 3T MR examination including DWI, DCE and DSC sequences. Two neuroradiologists objectively assessed the diffusion and perfusion maps by placing ROI on representative post-processed maps. They subjectively assessed the post-contrast, perfusion and diffusion sequences. Interrater agreement and concordance correlation coefficient were calculated.Results:Twenty-eight lesions were included. The interrater agreement on the qualitative assessment was good for k-trans (k = 0.73), moderate for Vp (k = 0.52), fair for AUC and Ve maps (k = 0.37 and 0.21), fair for corrected CBV (k = 0.39) and poor for the enhancement pattern and presence of diffusion restriction (k = 0.02 and 0.07). The concordance between the quantitative measurements was substantial for AUC and Vp (ρc = 0.98 and 0.97), moderate for k-trans and corrected CBV (ρc = 0.94) and poor for Ve and ADC (ρc = 0.86 and 0.24).Conclusion:While the quantitative measurements of DSC and DCE perfusion maps show satisfactory inter-rater agreement, the qualitative assessment has lower interobserver agreement and should not be relied upon solely in the interpretation. Similarly, the suboptimal inter-rater agreement on the interpretation of enhancement pattern and diffusion restriction potentially limits their usefulness in differentiating glioma recurrence from treatment related changes.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-05-17T01:50:00Z
      DOI: 10.1177/08465371211013568
       
  • US LI-RADS Visualization Score: Interobserver Variability and Association
           With Cause of Liver Disease, Sex, and Body Mass Index

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      Authors: Lauren Kiri, Mohamed Abdolell, Andreu F. Costa, Valerie Keough, Judy Rowe, Robinette Butt, Sharon E. Clarke
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Objectives:To evaluate the interobserver agreement between radiologists using the Ultrasound Liver Reporting And Data System (US LI-RADS) visualization score and assess association between visualization score and cause of liver disease, sex, and body mass index (BMI).Methods:This retrospective, single institution, cross-sectional study evaluated 237 consecutive hepatocellular carcinoma surveillance US examinations between March 4, 2017 and September 4, 2017. Five abdominal radiologists independently assigned a US LI-RADS visualization score (A, no or minimal limitations; B, moderate limitations; C, severe limitations). Interobserver agreement was assessed with a weighted Kappa statistic. Association between US visualization score (A vs B or C) and cause of liver disease, sex, and BMI (< or ≥ 25 kg/m2) was evaluated using univariate and multivariate analyses.Results:The average weighted Kappa statistic for all raters was 0.51. A score of either B or C was assigned by the majority of radiologists in 148/237 cases and was significantly associated with cause of liver disease (P = 0.014) and elevated BMI (P < 0.001). Subjects with viral liver disease were 3.32 times (95% CI: 1.44-8.38) more likely to have a score of A than those with non-alcoholic steatohepatitis (P = 0.007). The adjusted odds ratio of visualization score A was 0.249 (95% CI: 0.13-0.48) among those whose BMI was ≥25 kg/m2 vs. BMI < 25 kg/m2.Conclusion:Interobserver agreement between radiologists using US LI-RADS score was moderate. The majority of US examinations were scored as having moderate or severe limitations, and this was significantly associated with non-alcoholic steatohepatitis and increased BMI.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-05-03T02:33:34Z
      DOI: 10.1177/08465371211012104
       
  • Which Aspects of the CanMEDS Competencies are Most Valued in
           Radiologists' Perspectives of Trainees From Other Specialties

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      Authors: Stefanie Y. Lee, Namita Sharma, Yoan K. Kagoma, P. Andrea Lum
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Radiologists work primarily in collaboration with other healthcare professionals. As such, these stakeholder perspectives are of value to the development and assessment of educational outcomes during the transition to competency-based medical education. Our aim in this study was to determine which aspects of the Royal College CanMEDS competencies for diagnostic radiology are considered most important by future referring physicians.Methods:Institutional ethics approval was obtained. After pilot testing, an anonymous online survey was sent to all residents and clinical fellows at our university. Open-ended questions asked respondents to describe the aspects of radiologist service they felt were most important. Thematic analysis of the free-text responses was performed using a grounded theory approach. The resulting themes were mapped to the 2015 CanMEDS Key Competencies.Results:115 completed surveys were received from residents and fellows from essentially all specialties and years of training (out of 928 invited). Major themes were 1) timeliness and accessibility of service, 2) quality of reporting, and 3) acting as a valued team member. The competencies identified as important by resident physicians were largely consistent with the CanMEDS framework, although not all key competencies were covered in the responses.Conclusions:This study illustrates how CanMEDS roles and competencies may be exemplified in a concrete and specialty-specific manner from the perspective of key stakeholders. Our survey results provide further insight into specific objectives for teaching and assessing these competencies in radiology residency training, with the ultimate goal of improving patient care through strengthened communication and working relationships.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-04-28T05:45:03Z
      DOI: 10.1177/08465371211008649
       
  • Arteries of the Lower Limb—Embryology, Variations, and Clinical
           Significance

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      Authors: Emmad Qazi, Joerg Wilting, Neeral R. Patel, Abdullah O. Alenezi, Sean A. Kennedy, Kong T. Tan, Arash Jaberi, Sebastian Mafeld
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Objectives:The purpose of this article is to review the embryology of the lower limb arterial anatomy along with common variants and their clinical relevance.Design:Embryologic variations of the lower limb arterial system may be explained by i.) persistence of primordial arterial segments, ii.) abnormal fusion, iii.) segmental hypoplasia/absence, or a combination of both. Persistent sciatic artery, corona mortis, and popliteal entrapment syndrome will also be discussed with associated symptoms, and potential complications.Conclusion:Knowledge of these variations is essential for surgical and endovascular management as failure to recognize them can result in complications.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-04-22T05:34:51Z
      DOI: 10.1177/08465371211003860
       
  • Neuroimaging Findings of Hospitalized Covid-19 Patients: A Canadian
           Retrospective Observational Study

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      Authors: Vibeeshan Jegatheeswaran, Michael W. K. Chan, Sumon Chakrabarti, Adrian Fawcett, Yingming Amy Chen
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Coronavirus disease (COVID-19) has been associated with neurologic sequelae and neuroimaging abnormalities in several case series previously. In this study, the neuroimaging findings and clinical course of adult patients admitted with COVID-19 to a tertiary care hospital network in Canada were characterized.Methods:This is a retrospective observational study conducted at a tertiary hospital network in Ontario, Canada. All adult patients with PCR-confirmed COVID-19 admitted from February 1, 2020 to July 22, 2020 who received neuroimaging related to their COVID-19 admission were included. CT and MR images were reviewed and categorized by fellowship-trained neuroradiologists. Demographic and clinical data were collected and correlated with imaging findings.Results:We identified 422 patients admitted with COVID-19 during the study period. 103 (24.4%) met the inclusion criteria and were included: 30 ICU patients (29.1%) and 73 non-ICU patients (70.9%). A total of 198 neuroimaging studies were performed: 177 CTs and 21 MRIs. 17 out of 103 imaged patients (16.8%) had acute abnormalities on neuroimaging: 10 had macrohemorrhages (58.8%), 9 had acute ischemia (52.9%), 4 had SWI abnormalities (23.5%), and 1 had asymmetric sulcal effacement suggesting possible focal encephalitis (5.8%). ICU patients were more likely to have positive neuroimaging findings, more specifically acute ischemia and macrohemorrhages (P < 0.05). Macrohemorrhages were associated with increased mortality (P < 0.05).Conclusion:Macrohemorrhages, acute ischemia and SWI abnormalities were the main neuroimaging abnormalities in our cohort of hospitalized COVID-19 patients. Acute ischemia and hemorrhage were associated with worse clinical status.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-04-21T05:11:17Z
      DOI: 10.1177/08465371211002815
       
  • Tweeting Bias in Diagnostic Test Accuracy Research: Does Title or
           Conclusion Positivity Influence Dissemination'

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      Authors: Zachary Hallgrimson, Nicholas Fabiano, Jean-Paul Salameh, Lee M. Treanor, Robert A. Frank, Anahita Dehmoobad Sharifabadi, Matthew D. F. McInnes
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To examine if tweeting bias exists within imaging literature by determining if diagnostic test accuracy (DTA) studies with positive titles or conclusions are tweeted more than non-positive studies.Methods:DTA studies published between October 2011 to April 2016 were included. Positivity of titles and conclusions were assessed independently and in duplicate, with disagreements resolved by consensus. A negative binomial regression analysis controlling for confounding variables was performed to assess the relationship between title or conclusion positivity and tweets an article received in the 100 days post-publication.Results:354 DTA studies were included. Twenty-four (7%) titles and 300 (85%) conclusions were positive (or positive with qualifier); 1 (0.3%) title and 23 (7%) conclusions were negative; and 329 (93%) titles and 26 (7%) conclusions were neutral. Studies with positive, negative, and neutral titles received a mean of 0.38, 0.00, and 0.45 tweets per study; while those with positive, negative, and neutral conclusions received a mean of 0.44, 0.61, and 0.38 tweets per study. Regression coefficients were -0.05 (SE 0.46) for positive relative to non-positive titles, and -0.09 (SE 0.31) for positive relative to non-positive conclusions. The positivity of the title (P = 0.91) or conclusion (P = 0.76) was not significantly associated with the number of tweets an article received.Conclusions:The positivity of the title or conclusion for DTA studies does not influence the amount of tweets it receives suggesting that tweet bias is not present among imaging diagnostic accuracy studies. Study protocol available at https://osf.io/hdk2m/
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-04-20T08:19:33Z
      DOI: 10.1177/08465371211006420
       
  • Computed Tomography Angiography Assessment of Acute Aortic Syndromes:
           Classification, Differentiating Imaging Features, and Imaging
           Interpretation Pitfalls

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      Authors: Mana Modares, Kate Hanneman, Maral Ouzounian, Jennifer Chung, Elsie T. Nguyen
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      An acute aortic syndrome (AAS) is an important life-threatening condition that requires early detection and management. Acute intramural hematoma (IMH), aortic dissection (AD) and penetrating atherosclerotic ulcer (PAU) are included in AAS. ADs can be classified using the well-known Stanford or DeBakey classification systems. However, these classification systems omit description of arch dissections, anatomic variants, and morphologic features that impact outcome. The Society for Vascular Surgery and Society of Thoracic Surgeons (SVS-STS) have recently introduced a classification system that classifies ADs according to the location of the entry tear (primary intimomedial tear, PIT) and the proximal and distal extent of involvement, but does not include description of all morphologic features that may have diagnostic and prognostic significance. This review describes these classification systems for ADs and other AAS entities as well as their limitations. Typical computed tomography angiography (CTA) imaging appearance and differentiating features of ADs, limited intimal tears (LITs), IMHs, intramural blood pools (IBPs), ulcer-like projections (ULPs), and PAUs will be discussed. Furthermore, this review highlights common imaging interpretation pitfalls, what should be included in a comprehensive CTA report, and provides a brief overview of current management options.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-04-20T08:17:32Z
      DOI: 10.1177/08465371211001525
       
  • Does Immobilization Post Injection Reduce Contrast Extravasation in MR
           Arthrography of the Shoulder'

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      Authors: Caroline Muylaert, Cedric Boulet, Nico Buls, Scott Wuertzer, Nicole Pouliart, Freddy Machiels, Michel De Maeseneer
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Background:Contrast leakage after arthrography is common. We sought to investigate if immobilization could prevent it.Purpose:The purpose of this study was to determine the effects on contrast extravasation and image quality produced by strict immobilization of the shoulder between arthrography puncture and subsequent MR imaging.Material and methods:Fifty patients underwent shoulder MR arthrography using a standard shoulder puncture in the anteroinferior quadrant. Ten milliliters of contrast mixture of saline, iodinated contrast, and gadolinium contrast was injected by a senior musculoskeletal (MSK) radiologist using a 21G needle. Half of the patients were immediately immobilized using a shoulder sling, and the other half were allowed to move their shoulder and arm freely during the time before MR imaging. MR arthrography was performed with a 3 T system using standard T1 and PD weighted sequences. The MR images were reviewed independently by 2 MSK radiologists and graded for extravasation using a five-point scale (1: none, 2: less than 2 cm, 3: 2-5 cm, 4: 5-10 cm, 5: more than 10 cm) and for image quality using a 5 point scale (1: poor, 5: good). The Pearson correlation was calculated to assess the correlation between leakage and image quality.Results:There was no significant difference in amount of leakage between both groups, and global image quality was found equal in both groups. A negative correlation was found between leakage and quality assessment.Conclusion:This study shows that it cannot be avoided by strict shoulder immobilization and that it negatively affects image quality and interpretation.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-04-20T08:13:13Z
      DOI: 10.1177/08465371211005147
       
  • Updates to Reporting Computed Tomography Angiograms of Acute Aortic
           Syndromes

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      Authors: Andreu F. Costa, Bruce Precious
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-04-19T05:22:20Z
      DOI: 10.1177/08465371211010400
       
  • A New Parameter, the Smallest Oblique Sagittal Area of the Neural Foramen,
           as an Index to Diagnose Cervical Neural Foramen Stenosis

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      Authors: Yukun Jia, Zhan Peng, Jin Li, Guangye Wang
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Objective:The objective was to reconstruct the cervical neural foramen and accurately measure the minimum oblique sagittal area of the neural foramen. Then, a quantitative diagnostic standard for cervical neural foramen stenosis was proposed and its value as an indication for surgery was evaluated.Methods:(1) CT data were used to reconstruct the neural foramen using Mimics software, and the minimum area was measured. (2) The optimal cut-off value was determined using a receiver operating characteristic (ROC) curve. (3) Patients who underwent single-segment surgery were divided into 2 groups according to the cut-off value. Then the postoperative neurological function improvement rate was analyzed to identify any significant difference between the 2 groups.Results:A total of 1056 neural foramens were measured in 132 patients, of which 495 (46.88%) were diagnosed as radiculopathy by clinical neurological examination. The optimal cut-off value determined by the ROC curve was 25.95 mm2 (sensitivity 74.1%, specificity 80.9%) and the area under the curve (AUC) was 0.827 (95%CI: 0.803-0.849). There was a significant difference in the neurological function improvement rate between the 2 groups after surgery (P < 0.05). The intraclass correlation coefficient (ICC) was 0.969.Conclusion:Three-dimensional digital simulation reconstruction of CT data is a good measurement method. The optimal cut-off value determined here not only has a certain reference value for the diagnosis of cervical neural foramen bony stenosis, but also helps to select patients suitable for neural foramen decompression and can be used as a reference for surgical indication.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-04-19T05:15:06Z
      DOI: 10.1177/08465371211005540
       
  • I Wouldn’t Start From Here

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      Authors: Adrian P. Brady
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-03-30T05:19:49Z
      DOI: 10.1177/08465371211006063
       
  • Canadian Society of Thoracic Radiology/Canadian Association of
           Radiologists Best Practice Guidance for Investigation of Acute Pulmonary
           Embolism, Part 2: Technical Issues and Interpretation Pitfalls

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      Authors: Elsie T. Nguyen, Cameron Hague, Daria Manos, Brett Memauri, Carolina Souza, Jana Taylor, Carole Dennie
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      The investigation of acute pulmonary embolism is a common task for radiologists in Canada. Technical image quality and reporting quality must be excellent; pulmonary embolism is a life-threatening disease that should not be missed but overdiagnosis and unnecessary treatment should be avoided. The most frequently performed imaging investigation, computed tomography pulmonary angiogram (CTPA), can be limited by poor pulmonary arterial opacification, technical artifacts and interpretative errors. Image quality can be affected by patient factors (such as body habitus, motion artifact and cardiac output), intravenous (IV) contrast protocols (including the timing, rate and volume of IV contrast administration) and common physics artifacts (including beam hardening). Mimics of acute pulmonary embolism can be seen in normal anatomic structures, disease in non-vascular structures and pulmonary artery filling defects not related to acute pulmonary emboli. Understanding these pitfalls can help mitigate error, improve diagnostic quality and optimize patient outcomes. Dual energy computed tomography holds promise to improve imaging diagnosis, particularly in clinical scenarios where routine CTPA may be problematic, including patients with impaired renal function and patients with altered cardiac anatomy.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-03-30T05:14:46Z
      DOI: 10.1177/08465371211000739
       
  • Canadian Society of Thoracic Radiology/Canadian Association of
           Radiologists Best Practice Guidance for Investigation of Acute Pulmonary
           Embolism, Part 1: Acquisition and Safety Considerations

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      Authors: Elsie T. Nguyen, Cameron Hague, Daria Manos, Brett Memauri, Carolina Souza, Jana Taylor, Carole Dennie
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Acute pulmonary embolism (APE) is a well-recognized cause of circulatory system compromise and even demise which can frequently present a diagnostic challenge for the physician. The diagnostic challenge is primarily due to the frequency of indeterminate presentations as well as several other conditions which can have a similar clinical presentation. This often obliges the physician to establish a firm diagnosis due to the potentially serious outcomes related to this disease. Computed tomography pulmonary angiography (CTPA) has increasingly cemented its role as the primary investigation tool in this clinical context and is widely accepted as the standard of care due to several desired attributes which include great accuracy, accessibility, rapid turn-around time and the ability to suggest an alternate diagnosis when APE is not the culprit. In Part 1 of this guidance document, a series of up-to-date recommendations are provided to the reader pertaining to CTPA protocol optimization (including scan range, radiation and intravenous contrast dose), safety measures including the departure from breast and gonadal shielding, population-specific scenarios (pregnancy and early post-partum) and consideration of alternate diagnostic techniques when clinically deemed appropriate.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-03-30T05:11:44Z
      DOI: 10.1177/08465371211000737
       
  • Creating a Competency-Based Medical Education Curriculum for Canadian
           Diagnostic Radiology Residency (Queen’s Fundamental Innovations in
           Residency Education)-Part 2: Core of Discipline Stage

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      Authors: Siddharth Mishra, Andrew Chung, Christina Rogoza, Omar Islam, Benedetto Mussari, Xi Wang, Damon Dagnone, Nicholas Cofie, Nancy Dalgarno, Benjamin Y. M. Kwan
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:All postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) model divided into 4 stages of training. Queen’s University has been the first Canadian institution to mandate transitioning to CBME across all residency programs, including Diagnostic Radiology. This study describes the implementation of CBME with a focus on the third developmental stage, Core of Discipline, in the Diagnostic Radiology residency program at Queen’s University. We describe strategies applied and challenges encountered during the adoption and implementation process in order to inform the development of other CBME residency programs in Diagnostic Radiology.Methods:At Queen’s University, the Core of Discipline stage was developed using the Royal College of Physicians and Surgeons of Canada’s (RCPSC) competence continuum guidelines and the CanMEDS framework to create radiology-specific entrustable professional activities (EPAs) and milestones for assessment. New committees, administrative positions, and assessment strategies were created to develop these assessment guidelines. Currently, 2 cohorts of residents (n = 6) are enrolled in the Core of Discipline stage.Results:EPAs, milestones, and methods of evaluation for the Core of Discipline stage are described. Opportunities during implementation included tracking progress toward educational objectives and increased mentorship. Challenges included difficulty meeting procedural volume requirements, inconsistent procedural tracking, improving feedback mechanisms, and administrative burden.Conclusion:The transition to a competency-based curriculum in an academic Diagnostic Radiology residency program is significantly resource and time intensive. This report describes challenges faced in developing the Core of Discipline stage and potential solutions to facilitate this process.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-03-03T05:52:06Z
      DOI: 10.1177/0846537121993058
       
  • Does Carotid Artery Tortuosity Play a Role in Stroke'

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      Authors: Luca Saba, Roberto Sanfilippo, Jasjit S. Suri, Filippo Cademartiri, Giuseppe Corrias, Lorenzo Mannelli, Serena Zucca, Ignazio Senis, Roberto Montisci, Max Wintermark
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To explore the association between carotid artery length and tortuosity, and the occurrence of stroke.Material and Methods:In this retrospective study, IRB approved, 411 consecutive patients (males: 245; median age: 56 ± 12 years, age range: 21-93 years) with anterior circulation ischemic stroke were included. Only patients that underwent CTA within 7 days were considered and stroke caused by cardiac embolism and thoracic aorta embolism were excluded. For each patient, both carotid arteries were considered, and the ICA, CCA-ICA length and tortuosity were calculated. Inter-observer analysis was quantified with the Bland-Altman test. Mann-Whitney test and logistic regression analysis were also calculated to test the association between length and tortuosity with the occurrence of stroke.Results:In the final analysis, 166 patients (males: 72; median age: 54 ± 12 years, age range: 24-89 years) with anterior circulation ischemic stroke that were admitted to our hospital between February 2008 and December 2013 were included. The results showed a good concordance for the length of the vessels with a mean variation of 0.7% and 0.5% for CCA-ICA and ICA length respectively an for the tortuosity with a mean variation of 0.2% and -0.4% for CCA-ICA and ICA respectively. The analysis shows a statistically significant association between the tortuosity index of the ICA and CCA-ICA sides with stroke (P value = 0.0001 in both cases) and these findings were confirmed also with the logistic regression analysis.Conclusion:Results of this study suggest that tortuosity index is associated with the presence of stroke whereas the length of the carotid arteries does not play a significant role.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-03-03T05:50:06Z
      DOI: 10.1177/0846537121991057
       
  • Magnetic Resonance Imaging Provides Useful Diagnostic Information
           Following Equivocal Ultrasound in Children With Suspected Appendicitis

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      Authors: Jelena Komanchuk, Dori-Ann Martin, Rory Killam, Robin Eccles, Mary E. Brindle, Ijab Khanafer, Ari R. Joffe, Jaime Blackwood, Weiming Yu, Priya Gupta, Sanjay Sethi, Vijay Moorjani, Graham Thompson
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:In Canada, ultrasonography is the primary imaging modality for children with suspected appendicitis, yet equivocal studies are common. Magnetic resonance imaging provides promise as an adjunct imaging strategy. The primary objective of this study was to determine the proportion of children with suspected appendicitis and equivocal ultrasound where magnetic resonance imaging determined a diagnosis.Methods:A prospective consecutive cohort of children aged 5-17 years presenting to a tertiary pediatric Emergency Department with suspected appendicitis were enrolled. Participants underwent diagnostic and management strategies according to our local suspected appendicitis pathway, followed by magnetic resonance (Siemens Avanto 1.5 Tesla) imaging. Sub-specialty pediatric radiologists reported all images.Results:Magnetic resonance imaging was performed in 101 children with suspected appendicitis. The mean age was 11.9 (SD 3.4) years and median Pediatric Appendicitis Score was 6 [IQR 4,8]. Ultrasonography was completed in 98/101 (97.0%). Of 53/98 (54.1%) with equivocal ultrasound, magnetic resonance imaging provided further diagnostic information in 41 (77.4%; 10 positive, 31 negative; 12 remained equivocal). Secondary findings of appendicitis on magnetic resonance imaging in children with equivocal ultrasound included abdominal free fluid (24, 45.3%), peri-appendiceal fluid (12, 22.6%), intraluminal appendiceal fluid (9, 17.0%), fat stranding (8, 15.1%), appendicolith (2, 3.8%), and peri-appendiceal abscess (1, 1.9%). The observed agreement between magnetic resonance imaging results and final diagnosis was 94.9% (kappa = 0.89).
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-03-02T05:22:43Z
      DOI: 10.1177/0846537121993797
       
  • The Canadian Society of Breast Imaging/ Canadian Association of
           Radiologists’ Recommendations for the Management of Axillary Adenopathy
           in Patients With Recent COVID-19 Vaccination

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      Authors: Jean M. Seely, Michael H. Barry
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-02-24T07:38:07Z
      DOI: 10.1177/0846537121998949
       
  • Discontinuing Gonadal and Fetal Shielding in X-Ray

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      Authors: Yogesh Thakur, Stephanie C. Schofield, Thorarin A. Bjarnason, Michael N. Patlas
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-02-12T04:35:15Z
      DOI: 10.1177/0846537121993092
       
  • Quantitative Prostate MRI Analysis Following Fluvastatin Therapy for
           Localized Prostate Cancer - A Pilot Study

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      Authors: Allan Avery, Marshall Sussman, Joseph Longo, Ravi J. Menezes, Robert J. Hamilton, Theodorus H. van der Kwast, Neil E. Fleshner, Linda Z. Penn, Sangeet Ghai
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To assess the role of multi-parametric MRI (mpMRI) in assessment of tumor response to fluvastatin administered prior to radical prostatectomy.Methods:Men with MRI-visible, clinically significant prostate cancer and due to be treated with radical prostatectomy were prospectively enrolled. mpMRI was performed at baseline and following 6-7 week of neoadjuvant oral statin therapy (40 mg fluvastatin, twice daily), prior to prostatectomy. MRI assessment included tumor size, T2 relaxation time, ADC value, K-trans (volume transfer constant), Kep (reflux constant), and Ve (fractional volume) parameters at the 2 time points. Initial prostate needle biopsy cores, prior to starting oral statin therapy, corresponding to site of tumor on radical prostatectomy specimens were selected for analysis. The effect of fluvastatin on tumor proliferation (marker Ki67) and on tumor cell apoptosis (marker cleaved Caspase-3, CC3) were analyzed and correlated with MRI findings.Results:Nine men with paired MRI studies were included in the study. Binary histopathological data was available for 6 of the participants. No significant change in tumor size (P = 0.898), T2 relaxation time (P = 0.213), ADC value (P = 0.455), K-trans (P = 0.613), Kep (P = 0.547) or Ve (P = 0.883) between the time of biopsy and prostatectomy were observed. No significant change in tumor proliferation (%Ki67-positive cells, P = 0.766) was observed by immunohistochemistry analysis. However, there was a significant increase in tumor cell apoptosis (%CC3-positive cells, P = 0.047).Conclusion:mpMRI techniques may not be sufficiently sensitive to detect the types (or magnitude) of tumor cell changes observed following 6-7 weeks of fluvastatin therapy for prostate cancer.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-02-10T09:42:26Z
      DOI: 10.1177/0846537120988262
       
  • Keeping Pace: Our Experience With MR With Cardiac Devices

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      Authors: Demetrios A. Raptis, Pamela K. Woodard, Sanjeev Bhalla
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-02-10T07:23:34Z
      DOI: 10.1177/0846537121993080
       
  • Leadership Development Programs for Radiology Residents: A Literature
           Review

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      Authors: Aida Ahrari, Aazad Abbas, Rajesh Bhayana, Alison Harris, Linda Probyn
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Leadership development has become increasingly important in medical education, including postgraduate training in the specialty of radiology. Since leadership skills may be acquired, there is a need to establish leadership education in radiology residency training. However, there is a paucity of literature examining the design, delivery, and evaluation of such programs. The purpose of this study is to collate and characterize leadership training programs across postgraduate radiology residencies found in the literature.Methods:A scoping review was conducted. Relevant articles were identified through a search of Ovid MEDLINE, Ovid EMBASE, Cochrane, PubMed, Scopus, and ERIC databases from inception until June 22, 2020. English-language studies characterizing leadership training programs offered during postgraduate radiology residency were included. A search of the grey literature was completed via a web-based search for target programs within North America.Results:The literature search yielded 1168 citations, with 6 studies meeting inclusion criteria. Four studies were prospective case series and two were retrospective. There was heterogeneity regarding program structure, content, teaching methodology, and evaluation design. All programs were located in the United States. Outcome metrics and success of the programs was variably reported, with a mix of online and in person feedback used. The grey literature search revealed 3 American-based programs specifically catered to radiology residents, and none within Canada.Conclusion:The review highlighted a paucity of published literature describing leadership development efforts within radiology residency programs. The heterogeneity of programs highlighted the need for guidance from regulatory bodies regarding delivery of leadership curricula.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-02-05T10:05:24Z
      DOI: 10.1177/0846537120986495
       
  • Corrigendum to Etiology of Burnout in Canadian Radiologists and Trainees

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      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.

      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-02-05T05:04:45Z
      DOI: 10.1177/0846537121996546
       
  • Added Value of CT Pelvic Bone Unfolding Software to Radiologist
           Performance in Detecting Osteoblastic Pelvic Bone Lesions in Patients With
           Prostate Cancer

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      Authors: Mahinur Cerit, Koray Kılıç, Turkane Fetullayeva, Hatice Yağmur Zengin, Nesrin Erdoğan, Halit Nahit Şendur, Emetullah Cindil, Aydan Avdan Aslan, Gonca Erbaş
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:To evaluate the contribution of CT Bone Unfolding software to the diagnostic accuracy and efficiency for the detection of osteoblastic pelvic bone lesions in patients with prostate cancer.Methods:A total of 102 consecutive (January 2016-September 2019) patients who underwent abdominopelvic CT with prostate cancer were retrospectively evaluated for osteoblastic pelvic bone lesions, using commercially available the post-processing-pelvic bone flattening-image software package “CT Bone Unfolding.” Two radiologists with 3 and 15 years of experience in abdominal radiology evaluated CT image data sets independently in 2 separate reading sessions. At the first session, only MPR images and at the second session MPR images and additionally unfolded reconstructions were assessed. Reading time for each patient was noted. A radiologist with 25 years of experience, established the standard of reference.Results:In the evaluations performed with the MPR-Unfold method, the diagnostic accuracy were found to be 2.067 times higher compared to the MPRs method (P < 0.001). The location of the lesions or the reader variabilities did not show any influence on accuracy (P> 0.05) For all readers the reading time for MPR was significantly longer than for MPR-Unfold (P < 0.05). For both methods substantial to almost-perfect inter-reader agreement was found (0.686-0.936).Conclusions:The use of unfolded pelvic bone reconstructions increases diagnostic accuracy while decreasing the reading times in the evaluation of pelvic bone lesions. Therefore, our findings suggest that utilizing unfolded reconstructions in addition to MPR images may be preferable in patients with prostate cancer for the screening of osteoblastic pelvic bone lesions.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-01-21T08:03:05Z
      DOI: 10.1177/0846537120983241
       
  • Ultrasound as a Valuable Imaging Modality in Sclerosing Lymphocytic
           Lobulitis: Imaging Features Based on a Retrospective Cohort Analysis of 51
           Cases

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      Authors: Lucy Tiemi Sato, Giselle Guedes Netto de Mello, Monica Maria Agata Stiepcich, Tatiana Cardoso de Mello Tucunduva, Ulysses S. Torres, André Fernandes Reis, Henrique Manoel Lederman
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:Sclerosing lymphocytic lobulitis (SLL) is a rare benign breast condition usually associated with diabetes mellitus and whose imaging features have been assessed in few studies, limiting the adoption of diagnostic guidelines. We aimed to identify the main morphological features associated with SLL on imaging examinations (mainly ultrasound and mammography) and to retrospectively evaluate the role that each method played in the diagnostic workup (detection and indication for biopsy).Methods:A retrospective study was conducted in a high-volume single center, encompassing 51 consecutive patients (100% female; 26-78 y; 43.7 ± 15.5 y) with histopathologically proven SLL (59 lesions; 0.5-6.1 cm).Results:Most lesions (31/59; 53%) were found in asymptomatic individuals. Ultrasound detected 91.1% (51 out of 56 lesions assessed by this modality), of which 94.1% were non-circumscribed masses (BI-RADS® 4). Mammography detected 41.6% (15 out of 36 lesions assessed by this modality), with a predominance (80%) of non-calcified ones (masses, asymmetries and distortion). Two-year follow-up was achieved in 29 lesions (49%), showing complete remission (45%) or stability (41%) in most cases.Conclusions:Most lesions in this retrospective sample have been detected by means of ultrasound and had their need for biopsy indicated by this modality. Female diabetic patients younger than 40 years presenting with a palpable lesion and a non-circumscribed mass on ultrasound could be submitted to core biopsy; histopathologic findings suggestive of SLL should be considered concordant in this scenario, with subsequent conservative treatment.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-01-19T05:58:20Z
      DOI: 10.1177/0846537120983122
       
  • Diagnostic Neuroradiology Subspecialty Training: 1 Versus 2 Years; the
           Canadian Perspective

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      Authors: Pejman Jabehdar Maralani, Jason R. Shewchuk, Manish Joshi, Luciana Ribeiro, Raquel del Carpio-O’Donovan, David Landry, Manas Sharma, Nader Zakhari, Sean Symons, William Morrish, Matthias Schmidt
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Background:Canada began a national reform of its post-graduate medical education training programs to a Competence By Design (CBD) model. Trends from accredited neuroradiology programs from the past 10 years were investigated to inform educators and stakeholders for this process.Methods:A 13-question electronic survey was sent to program directors of all 8 accredited neuroradiology training programs in Canada. Data was requested for each year on the 2008-2019 graduating classes. Questions pertained to program enrolment; program completion; post-training employment; and the sufficiency of 1-year training programs.Results:Response rate was 100%. Over the timeframe studied, the 2-year programs increased in size (P = 0.007), while the 1-year programs remained steady (P = 0.27). 12.2% of trainees enrolled in the 2-year program dropped out after 1 year, and were considered 1-year trainees thereafter. A higher proportion of 2-year trainees obtain positions within academic institutions (89.5 vs 67.2%, P = 0.0007), whereas a higher proportion of 1-year trainees obtain positions within non-academic institutions (29.3 vs 8.1%, P = 0.0007). A higher proportion of those with Canadian board certification in diagnostic radiology who completed a 2-year program obtained a position within a Canadian academic institution compared to non-certified 2-year trainees (P < 0.001). 71.4% of program directors agreed that a 1-year program was sufficient for non-academic staff positions.Conclusion:The length of the training program has significant impact on employment in academic vs non-academic institutions. This information can be used to guide the upcoming CBD initiative for neuroradiology programs.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-01-19T05:56:12Z
      DOI: 10.1177/0846537120982984
       
  • Diagnostic Radiology Residency Assessment Tools: A Scoping Review

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      Authors: Wendy Tu, Rebecca Hibbert, Mario Kontolemos, Wilfred Dang, Tim Wood, Raman Verma, Matthew D. F. McInnes
      Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
      Purpose:The multifaceted nature of learning in diagnostic radiology residency requires a variety of assessment methods. However, the scope and quality of assessment tools has not been formally examined. A scoping review was performed to identify assessment tools available for radiology resident training and to evaluate the validity of these tools.Methods:A literature search was conducted through multiple databases and on-line resources. Inclusion criteria were defined as any tool used in assessment of radiology resident competence. Data regarding residents, evaluators and specifics of each tool was extracted. Each tool was subjected through a validation process with a customized rating scale using the 5 categories of validity: content, response process, internal structure, relations to other variables, and consequences.Results:The initial search returned 447 articles; 35 were included. The most evaluated competency being overall knowledge (31%), most common published journal was Academic Radiology (24%); evaluations were most commonly set in the United States (57%). In terms of validation, we found low adherence to modern integrated validity, with 34% of studies including a definition of validity. When specifically examining the 5 domains of validation evidence presented, most were either absent or of low rigor (70%). Only one study presented a modern definition of validation (3%, 1/35).Conclusion:We identified 35 evaluation tools covering a variety of competency areas. However, few of these tools have been validated. Development of new validated assessment tools or validation of existing tools is essential for the ongoing transition to a competency-based curriculum.
      Citation: Canadian Association of Radiologists Journal
      PubDate: 2021-01-06T06:24:42Z
      DOI: 10.1177/0846537120981581
       
 
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