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Canadian Association of Radiologists Journal
Journal Prestige (SJR): 0.463

Citation Impact (citeScore): 1
Number of Followers: 1

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ISSN (Print) 0846-5371 - ISSN (Online) 1488-2361
Published by Sage Publications

[1176 journals]

Response to ChatGPT in Radiology: A Deeper Look Into its Limitations and
Potential Pathways for Improvement
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  Authors: Matthias W. Wagner, Birgit B. Ertl-Wagner
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-06-07T09:28:32Z
  DOI: 10.1177/08465371231181910
Community-Based Breast Cancer Screening: A Grassroots Approach to Address
Racial Disparities in Detection and Diagnosis
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  Authors: Sonali Sharma, Michael Patlas, Charlotte J. Yong-Hing
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-05-25T07:45:40Z
  DOI: 10.1177/08465371231180311
Non-Enhancing Tissue on Diabetic Foot Magnetic Resonance Imaging in
Relation to Osteomyelitis Investigation: Magnetic Resonance Imaging
Performance, Pitfalls and Clinical Considerations
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  Authors: Juvel Lee, Bruce B. Forster
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-05-22T04:03:47Z
  DOI: 10.1177/08465371231179461
Automated MRI Protocolling and Scheduling: A Multi-Institutional Survey
and Results
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  Authors: Pratik Gajiwala, Kyle Eckhardt, Adnan Sheikh, Khaldon Abbas, Emily Davies, William Parker
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-05-22T03:18:08Z
  DOI: 10.1177/08465371231176550
Abdominal Emergencies in Cancer Patients
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  Authors: Mariano Scaglione, Salvatore Masala, Stefania Tamburrini, Giulia Lassandro, Luigi Barbuto, Luigia Romano, Francesca Iacobellis, Giacomo Sica, Paola Crivelli, Davide Turilli, Fabio Sandomenico, Vincenza Granata, Michael N Patlas
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Abdominal emergencies in cancer patients encompass a wide spectrum of oncologic conditions caused directly by malignancies, paraneoplastic syndromes, reactions to the chemotherapy or often represent the first clinical manifestation of an unknown malignancy. Not rarely, clinical symptoms are the tip of an iceberg. In this scenario, the radiologist is asked to exclude the cause responsible for the patient’s symptoms, to suggest the best way to manage and to rule out the underlying malignancy. In this article, we discuss some of the most common abdominal oncological emergencies that may be encountered in an emergency department.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-05-16T06:57:44Z
  DOI: 10.1177/08465371231175521
Recommendations for Improvement of Equity, Diversity, and Inclusion in the
CaRMs Selection Process
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  Authors: Jana Taylor, Sonali Sharma, Alanna Supersad, Elka Miller, Kiana Lebel, Joanne Zabihaylo, Phyllis Glanc, Andrea S. Doria, Paula Cashin, Tracey Hillier, Charlotte J. Yong-Hing
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Equity, diversity and inclusion (EDI) in the medical field is crucial for meeting the healthcare needs of a progressively diverse society. A diverse physician workforce enables culturally sensitive care, promotes health equity, and enhances the comprehension of the various needs and viewpoints of patients, ultimately resulting in more effective treatments and improved patient outcomes. However, despite the recognized benefits of diversity in the medical field, certain specialties, such as Radiology, have struggled to achieve adequate equity, diversity and inclusion, which results in a discrepancy in the demographics of Canadian radiologists and the patients we serve. In this review, we propose strategies from a committee within the Canadian Association of Radiologists (CAR) EDI working group to improve EDI in the CaRMS selection process. By adopting these strategies, residency programs can foster a more diverse and inclusive environment that is better positioned to address the health needs of a progressively diverse patient population, leading to improved patient outcomes, greater patient satisfaction, and advancements in medical innovation.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-05-13T05:08:02Z
  DOI: 10.1177/08465371231174897
ChatGPT in Radiology: A Deeper Look Into its Limitations and Potential
Pathways for Improvement
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  Authors: Partha Pratim Ray, Poulami Majumder
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-05-12T11:42:30Z
  DOI: 10.1177/08465371231177674
Editor’s Corner: November 2023
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  Authors: Jacky C. K. Chow, Michael N. Patlas
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-05-09T01:56:54Z
  DOI: 10.1177/08465371231176726
The Rising Utilization of Opportunistic CT Screening and Machine Learning
in Bone Mineral Density
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  Authors: Nicholas M. Beckmann
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-05-06T07:42:05Z
  DOI: 10.1177/08465371231176716
Watching Innovation in Real Time: The Story of ChatGPT and Radiology
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  Authors: Elliot K. Fishman, William B. Weeks, Juan M. Lavista Ferres, Linda C. Chu
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-05-04T03:48:32Z
  DOI: 10.1177/08465371231174817
Advanced Imaging Technology: Photon Counting CT
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  Authors: Sabeena Jalal, Savvas Nicolaou
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-29T11:30:03Z
  DOI: 10.1177/08465371231172738
Accuracy of Information and References Using ChatGPT-3 for Retrieval of
Clinical Radiological Information
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  Authors: Matthias W. Wagner, Birgit B. Ertl-Wagner
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Purpose: To assess the accuracy of answers provided by ChatGPT-3 when prompted with questions from the daily routine of radiologists and to evaluate the text response when ChatGPT-3 was prompted to provide references for a given answer. Methods: ChatGPT-3 (San Francisco, OpenAI) is an artificial intelligence chatbot based on a large language model (LLM) that has been designed to generate human-like text. A total of 88 questions were submitted to ChatGPT-3 using textual prompt. These 88 questions were equally dispersed across 8 subspecialty areas of radiology. The responses provided by ChatGPT-3 were assessed for correctness by cross-checking them with peer-reviewed, PubMed-listed references. In addition, the references provided by ChatGPT-3 were evaluated for authenticity. Results: A total of 59 of 88 responses (67%) to radiological questions were correct, while 29 responses (33%) had errors. Out of 343 references provided, only 124 references (36.2%) were available through internet search, while 219 references (63.8%) appeared to be generated by ChatGPT-3. When examining the 124 identified references, only 47 references (37.9%) were considered to provide enough background to correctly answer 24 questions (37.5%). Conclusion: In this pilot study, ChatGPT-3 provided correct responses to questions from the daily clinical routine of radiologists in only about two thirds, while the remainder of responses contained errors. The majority of provided references were not found and only a minority of the provided references contained the correct information to answer the question. Caution is advised when using ChatGPT-3 to retrieve radiological information.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-20T10:50:18Z
  DOI: 10.1177/08465371231171125
Opportunistic Extraction of Quantitative CT Biomarkers: Turning the
Incidental Into Prognostic Information
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  Authors: Mohammad Nazri Md Shah, Raja Rizal Azman, Wai Yee Chan, Kwan Hoong Ng
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  The past two decades have seen a significant increase in the use of CT, with a corresponding rise in the mean population radiation dose. This rise in CT use has caused improved diagnostic certainty in conditions that were not previously routinely evaluated using CT, such as headaches, back pain, and chest pain. Unused data, unrelated to the primary diagnosis, embedded within these scans have the potential to provide organ-specific measurements that can be used to prognosticate or risk-profile patients for a wide variety of conditions. The recent increased availability of computing power, expertise and software for automated segmentation and measurements, assisted by artificial intelligence, provides a conducive environment for the deployment of these analyses into routine use. Data gathering from CT has the potential to add value to examinations and help offset the public perception of harm from radiation exposure. We review the potential for the collection of these data and propose the incorporation of this strategy into routine clinical practice.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-19T08:45:52Z
  DOI: 10.1177/08465371231171700
T1 and T2 Mapping - A New Road to the Diagnosis of Anterior Mediastinal
Lesions'
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  Authors: Carolina A Souza
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-18T12:38:56Z
  DOI: 10.1177/08465371231172412
Non-Enhancing Tissue on Diabetic Foot Magnetic Resonance Imaging in
Relation to Osteomyelitis Investigation: Magnetic Resonance Imaging
Performance, Pitfalls and Clinical Considerations
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  Authors: Inas Slim, Aisin Ibrahim, Sooheib Andoulsi, Charles-Antoine Beaulieu, Véronique Freire
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Background: Geographic non-enhancing zones in diabetic foot magnetic resonance imaging (MRI) were first described in 2002. No previous report has described the impact and clinical significance of geographic non-enhancing tissue seen in the evaluation of diabetic foot MRI. Purpose: To evaluate the prevalence of devascularization areas on contrast-enhanced MRI in diabetic patients suspected of having foot osteomyelitis, the impact on the performance of the MRI assessment, and the possible pitfalls. Methods: A retrospective study was conducted between January 2016 and December 2017 during which 72 CE-MRIs of 1.5 and 3T were reviewed by 2 musculoskeletal radiologists for the presence of non-enhancing tissue areas and for osteomyelitis. A blinded third party collected clinical data including pathology reports, revascularization procedures, and surgical interventions. The prevalence of devascularization was calculated. Results: Among the 72 CE-MRIs (54 men, 18 women; mean age 64), 28 demonstrated non-enhancing areas (39%). All but 6 patients were found to have been correctly diagnosed on imaging (3 false positives, 2 false negatives, and 1 non-diagnostic). A greater discordance was also observed between the radiological and pathological diagnoses in the MRIs which showed non-enhancing tissue. Conclusion: Non-enhancing tissue is found in a non-negligible portion of diabetic foot MRIs and affects its diagnostic performance when looking for osteomyelitis. The recognition of these areas of devascularization may be helpful for the physician in planning the best treatment option for the patient.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-18T03:07:18Z
  DOI: 10.1177/08465371231167595
Clinical Features, Non-Contrast CT Radiomic and Radiological Signs in
Models for the Prediction of Hematoma Expansion in Intracerebral
Hemorrhage
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  Authors: Zejia Frank Chen, Liying Zhang, André M Carrington, Rebecca Thornhill, Olivier Miguel, Angela M Auriat, Nima O Fard, Shiva Hiremath, Vered Tshemeister Abitbul, Dar Dowlatshahi, Andrew Demchuk, David Gladstone, Andrea Morotti, Ilaria Casetta, Enrico Fainardi, Thien Huynh, Marah Elkabouli, Zoé Talbot, Gerd Melkus, Richard I Aviv
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  PurposeRapid identification of hematoma expansion (HE) risk at baseline is a priority in intracerebral hemorrhage (ICH) patients and may impact clinical decision making. Predictive scores using clinical features and Non-Contract Computed Tomography (NCCT)-based features exist, however, the extent to which each feature set contributes to identification is limited. This paper aims to investigate the relative value of clinical, radiological, and radiomics features in HE prediction.MethodsOriginal data was retrospectively obtained from three major prospective clinical trials [“Spot Sign” Selection of Intracerebral Hemorrhage to Guide Hemostatic Therapy (SPOTLIGHT)NCT01359202; The Spot Sign for Predicting and Treating ICH Growth Study (STOP-IT)NCT00810888] Patients baseline and follow-up scans following ICH were included. Clinical, NCCT radiological, and radiomics features were extracted, and multivariate modeling was conducted on each feature set.Results317 patients from 38 sites met inclusion criteria. Warfarin use (p=0.001) and GCS score (p=0.046) were significant clinical predictors of HE. The best performing model for HE prediction included clinical, radiological, and radiomic features with an area under the curve (AUC) of 87.7%. NCCT radiological features improved upon clinical benchmark model AUC by 6.5% and a clinical & radiomic combination model by 6.4%. Addition of radiomics features improved goodness of fit of both clinical (p=0.012) and clinical & NCCT radiological (p=0.007) models, with marginal improvements on AUC. Inclusion of NCCT radiological signs was best for ruling out HE whereas the radiomic features were best for ruling in HE.ConclusionNCCT-based radiological and radiomics features can improve HE prediction when added to clinical features.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-18T01:07:58Z
  DOI: 10.1177/08465371231168383
Disparities in Radiologist Fee-For-Service Payments by Gender in Canada
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  Authors: Hayley McKee, Cynthia Walsh, Mana Modares, Wan Wan Yap, Natalia Gorelik, Maura Brown, Charlotte J Yong-Hing, Kate Hanneman
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Objective: To examine differences in fee-for-service (FFS) payments to men and women radiologists in Canada and evaluate potential contributors. Methods: Publicly available FFS radiology billing data was analyzed from British Columbia (BC), Ontario (ON), Prince-Edward Island (PEI) and Nova Scotia (NS) between 2017 and 2021. Data was analyzed by gender on a per-province and national level. Variables evaluated included year, province, procedure billings, and days worked (BC and ON only). The gender pay gap was expressed as the difference in mean billing payments between men and women divided by mean payments to men. Results: Data points from 8478 radiologist years were included (2474 [29%] women and 6004 [71%] men). The unadjusted difference in annual FFS billings between men and women was $126,657. Overall, payments to women were 81% of payments to men with a 19% gender pay gap. The difference in billings between men and women did not change significantly between 2017 and 2021 (range in gender pay gap, 17–21%) but did vary by province (highest gap NS). Compared to men, women worked fewer days per year (weighted mean 218 ± 29 vs 236 ± 25 days/year, P < .001, 8% difference). Conclusion: In an analysis of fee-for-service payments to radiologists in 4 Canadian provinces between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap. Payments were lower to women across all years evaluated. Women worked 8% fewer days per year on average than men, which did not fully account for the difference in FFS billing payments between men and women. Summary Statement: In an analysis of fee-for-service payments to Canadian radiologists between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap which is not fully accounted for by time spent working.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-17T09:42:16Z
  DOI: 10.1177/08465371231170630
Corrigendum to “Low Tube Voltage Chest Computed Tomography With
Enhancement Using Low-Concentration Iodinated Contrast Media: Comparison
of 240 mg/mL Versus 300 mg/mL Iodinated Contrast Media”
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  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-15T09:15:16Z
  DOI: 10.1177/08465371231169347
Adverse Events Self-Reporting in Radiology:A New Avenue for Excellence
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  Authors: Philippe Soyer, Michael N. Patlas
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-14T02:02:45Z
  DOI: 10.1177/08465371231171597
Appropriateness of Recommendations Provided by ChatGPT to Interventional
Radiologists
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  Authors: Maxime Barat, Philippe Soyer, Anthony Dohan
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Purpose: The purpose of this study was to analyze the answers provided by ChatGPT to various questions in the field of interventional radiology (IR) and compare their correctness to a consensus of three interventional radiologists. Materials and Methods. Twenty questions were proposed to the online chat based ChatGPT about interventional radiology as indications for exams, complications and technical points. Answers were independently evaluated by 3 experts in interventional radiology with 10, 15 and 30 years or experiences and classified as correct, almost correct, or wrong. Results: Considering the consensus between the two IR, nine (9/20; 45%) were considered wrong, three (3/20; 15%) were considered almost correct and eight (8/20; 40%) were considered correct. Conclusion: ChatGPT can be useful in IR but the users must be aware of limitations such as too vague or inaccurate answers for the majority of questions.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-13T03:20:43Z
  DOI: 10.1177/08465371231170133
Assessing the Effects of Deep Learning Reconstruction on Abdominal CT
Without Arm Elevation
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  Authors: Nana Fujita, Koichiro Yasaka, Akira Katayama, Yuta Ohtake, Mao Konishiike, Osamu Abe
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Purpose: To evaluate the effects of deep learning reconstruction (DLR) on image quality of abdominal computed tomography (CT) in patients without arm elevation compared with hybrid-iterative reconstruction (Hybrid-IR) and filtered back projection (FBP). Methods: In this retrospective study, axial images of 26 patients who underwent CT without arm elevation were reconstructed using DLR, Hybrid-IR, and FBP. Streak artifact index (SAI) was calculated by dividing the standard deviation of CT attenuation in the liver or spleen by that in fat. Two other blinded radiologists evaluated streak artifacts on images (in the liver, spleen, and kidney), depiction of liver vessels, subjective image noise, and overall quality. They were also asked to detect space-occupying lesions other than cysts in the liver, spleen, and kidney. Results: The SAI (liver/spleen) in DLR images was significantly reduced compared with Hybrid-IR and FBP. Regarding qualitative image analysis, streak artifacts in the 3 organs, qualitative image noise, and overall quality in DLR images were rated by both readers as significantly improved compared with Hybrid-IR (P ≤ .012) and FBP (P < .001). Both blinded readers detected more lesions on DLR images than on Hybrid-IR and FBP ones. Conclusion: DLR resulted in significantly better-quality abdominal CT images in patients scanned without elevating their arms with reducing streak artifacts compared with Hybrid-IR and FBP.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-12T04:43:00Z
  DOI: 10.1177/08465371231169672
CAR Practice Statement on Advanced Pelvic Ultrasound for Endometriosis
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  Authors: Basma Al-Arnawoot, Silvia Chang, Shauna Duigenan, Ania Z. Kielar, Mathew Leonardi
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  The Canadian Association of Radiologists (CAR) Endometriosis Working Group was tasked with providing guidance and benchmarks to ensure the quality of technique and interpretation for advanced imaging modalities associated with diagnosing endometriosis. This practice statement provides an overview of the state of the art of advanced pelvic ultrasound in the diagnosis and mapping of pelvic endometriosis. While acknowledging that advanced pelvic ultrasound in some practices falls within the scope of clinical colleagues rather than imaging departments, the statement seeks to guide radiologists interested in implementing these techniques into their practice for patients referred for evaluation and diagnosis of endometriosis. The statement covers indications, some components of the ultrasound assessment and technique, reporting, and recommendations for starting an ultrasound endometriosis evaluation program.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-12T02:18:55Z
  DOI: 10.1177/08465371231165986
Equity, Diversity and Inclusion in Radiology: Prioritizing Trainee
Involvement
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  Authors: Sonali Sharma, Michael Patlas, Faisal Khosa, Charlotte J. Yong-Hing
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-10T02:07:00Z
  DOI: 10.1177/08465371231170230
Retrospective Evaluation of Splenic Artery Embolization Outcomes in the
Management of Blunt Splenic Trauma: A Single Centre Experience at a Large
Level 1 Trauma Centre
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  Authors: C O’Rourke, H McKee, DO Wijeyaratnam, J Bajwa, L Tremblay, E David
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  PurposeRetrospective review of splenic artery embolization (SAE) outcomes performed for blunt abdominal trauma.Materials and Methods11-year retrospective review at a large level-1 Canadian trauma centre. All patients who underwent SAE after blunt trauma were included. Technical success was defined as angiographic occlusion of the target vessel and clinical success was defined as successful non-operative management and splenic salvage on follow-up.Results138 patients were included of which 68.1% were male. The median age was 47 years (interquartile range (IQR) = 32.5 years). The most common mechanisms of injury were motor vehicle accidents (37.0%), mechanical falls (25.4%), and pedestrians hit by motor vehicles (10.9%). 70.3% of patients had American Association for the Surgery of Trauma (AAST) grade 4 injuries. Patients were treated with proximal SAE (n = 97), distal SAE (n = 23) or combined SAE (n = 18), and 68% were embolized with an Amplatzer plug. No significant differences were observed across all measures of hospitalization (Length of hospital stay: x2(2) = .358, P = .836; intensive care unit (ICU) stay: x2(2) = .390, P = .823; ICU stay post-procedure: x2(2) = 1.048, P = .592). Technical success and splenic salvage were achieved in 100% and 97.8% of patients, respectively. 7 patients (5%) had post-embolization complications and 7 patients (5%) died during hospital admission, but death was secondary to other injuries sustained in the trauma rather than complications related to splenic injury or its management.ConclusionWe report that SAE as an adjunct to non-operative management of blunt splenic trauma can be performed safely and effectively with a high rate of clinical success.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-07T11:03:54Z
  DOI: 10.1177/08465371231166946
Typology, Severity, and Outcomes of Adverse Events Related to Angiographic
Equipment—A Ten-Year Analysis of the FDA MAUDE Database
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  Authors: Gerard M. Healy, Aida Ahrari, Fahd Alkhalifah, George Oreopoulos, Kong Teng Tan, Arash Jaberi, Sebastian Mafeld
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Purpose: Angiographic equipment is a key component of healthcare infrastructure, used for endovascular procedures throughout the body. The literature on adverse events related to this technology is limited. The purpose of this study was to analyze adverse events related to angiographic devices from the US Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database. Methods: MAUDE data on angiographic imaging equipment from July 2011 to July 2021 were extracted. Qualitative content analysis was performed, a typology of adverse events was derived, and this was used to classify the data. Outcomes were assessed using the Healthcare Performance Improvement (HPI) and Society of Interventional Radiology (SIR) adverse event classifications. Results: There were 651 adverse events reported. Most were near misses (67%), followed by precursor safety events (20.5%), serious safety events (11.2%), and unclassifiable (1.2%). Events impacted patients (42.1%), staff (3.2%), both (1.2%), or neither (53.5%). The most common events associated with patient harm were intra-procedure system shut down, foot pedal malfunction, table movement malfunction, image quality deterioration, patient falls, and fluid damage to system. Overall, 34 (5.2%) events were associated with patient death; 18 during the procedure and 5 during patient transport to another angiographic suite/hospital due to critical failure of equipment. Conclusion: Adverse events related to angiographic equipment are rare; however, serious adverse events and deaths have been reported. This study has defined a typology of the most common adverse events associated with patient and staff harm. Increased understanding of these failures may lead to improved product design, user training, and departmental contingency planning.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-06T10:02:55Z
  DOI: 10.1177/08465371231167990
Canadian Association of Radiologists Diagnostic Imaging Referral
Guidelines
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  Authors: Candyce Hamel, Marc Venturi, Ryan Margau, Paul Pageau
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-05T04:38:01Z
  DOI: 10.1177/08465371231169746
Optimising Outpatient Oral Contrast Use in Abdominal CT–A Radiology
Pandemic Response Initiative to Reduce Patient Time in the Waiting Room
and Reduce Costs, While Improving Patient Experience
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  Authors: Mary Renton, Ania Z. Kielar, Daniel Toubassy, Mary May, Manjula Maganti, Corwin Burton, Satheesh Krishna
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Purpose: The aim was to reduce outpatient wait time and improve patient experience by optimising oral contrast use. Methods: Our multidisciplinary stakeholder collaboration implemented two simultaneous interventions: (1) Creation of ‘oral contrast policy’, limiting recommended indications. (2) Creation of a new shorter oral contrast regime (30 vs 60 min). We conducted a retrospective service evaluation of oral contrast use in outpatient (OP) abdominal CT at baseline and post-intervention. Patient wait times were measured and per-patient cost-savings were reported. An image quality review was performed by 2 blinded abdominal radiologists. Patient experience was evaluated with a standard voluntary survey. Statistical analysis was performed comparing baseline and evaluation outcomes using Chi-square or Fisher Exact test for categorical variables and Student’s t-test or ANOVA for continuous data. Results: Over 1-month periods, OP CT scans were assessed in baseline (pre-pandemic) n = 575, baseline (pandemic) n = 495 and post-intervention n = 545 groups. Oral contrast use reduced from 420/575, 73.0% at baseline to 178/545, 32.7% post intervention. The turn-around time reduced by 15.8 minutes per patient from 70.3 to 54.5 minutes, P < .001 (Interventions 1 and 2). The diagnostic quality did not differ between the oral contrast regimes (Intervention 2, P = 1.0, P = .08). No repeat CTs were needed due to lack of oral contrast (Intervention 1) or poor opacification (Intervention 2). There was oral contrast cost reductions of 69.1–78.4% (P < .001). Patients reported their overall experience was improved post-intervention (Interventions 1 and 2). Conclusions: Optimising the CT oral contrast service through judicious use and a shorter regime, reduced patient wait times, improved patient experience and preserved diagnostic quality.Summary statementOptimising the CT oral contrast service through judicious use and a shorter regime, reduced patient wait-times, improved patient experience and preserved diagnostic quality.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-04-03T11:29:28Z
  DOI: 10.1177/08465371231166381
Machine Learning for Opportunistic Screening for Osteoporosis and
Osteopenia Using Knee CT Scans
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  Authors: Ronnie Sebro, Mahmoud Elmahdy
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  PurposeTo predict whether a patient has osteoporosis/osteopenia using the attenuation of trabecular bone obtained from knee computed tomography (CT) scans.MethodsRetrospective analysis of 273 patients who underwent contemporaneous knee CT scans and dual-energy X-ray absorptiometry (DXA) within 1 year. Volumetric segmentation of the trabecular bone of the distal femur, proximal tibia, patella, and proximal fibula was performed to obtain the bone CT attenuation. The data was randomly split into training/validation (78%) and test (22%) datasets and the performance in the test dataset were evaluated. The predictive properties of the CT attenuation of each bone to predict osteoporosis/osteopenia were assessed. Multivariable support vector machines (SVM) and random forest classifiers (RF) were used to predict osteoporosis/osteopenia.ResultsPatients with a mean age (range) of 67.9 (50–87) years, 85% female were evaluated. Seventy-seven (28.2%) of patients had normal bone mineral density (BMD), 140 (51.3%) had osteopenia, and 56 (20.5%) had osteoporosis. The proximal tibia had the best predictive ability of all bones and a CT attenuation threshold of 96.0 Hounsfield Units (HU) had a sensitivity of .791, specificity of .706, and area under the curve (AUC) of .748. The AUC for the SVM with cubic kernel classifier (AUC = .912) was better than the RF classifier (AUC = .683, P < .001) and better than using the CT attenuation threshold of 96.0 HU at the proximal tibia (AUC = .748, P = .025).ConclusionsOpportunistic screening for osteoporosis/osteopenia can be performed using knee CT scans. Multivariable machine learning models are more predictive than the CT attenuation of a single bone.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-03-24T11:17:50Z
  DOI: 10.1177/08465371231164743
Automated Adolescence Scoliosis Detection Using Augmented U-Net With
Non-square Kernels
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  Authors: Yujie Wu, Khashayar Namdar, Chaojun Chen, Shahob Hosseinpour, Manohar Shroff, Andrea S. Doria, Farzad Khalvati
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Purpose: Scoliosis is a deformity of the spine, and as a measure of scoliosis severity, Cobb angle is fundamental to the diagnosis of deformities that require treatment. Conventional Cobb angle measurement and assessment is usually done manually, which is inherently time-consuming, and associated with high inter- and intra-observer variability. While there exist automatic scoliosis measurement methods, they suffer from insufficient accuracy. In this work, we propose a two-step segmentation-based deep learning architecture to automate Cobb angle measurement for scoliosis assessment using X-Ray images. Methods: The proposed architecture involves two steps. In the first step, we utilize a novel Augmented U-Net architecture to generate segmentations of vertebrae. The second step includes a non-learning-based pipeline to extract landmark coordinates from the segmented vertebrae and filter undesirable landmarks. Results: Our proposed Augmented U-Net architecture achieved a Symmetric Mean Absolute Percentage Error of 9.2%, with approximately 90% of estimations having less than 10 degrees difference compared with the AASCE-MICCAI challenge 2019 dataset ground truths. We further validated the model using an internal dataset and achieved almost the same level of performance. Conclusion: The proposed architecture is robust in providing automated spinal vertebrae segmentations and Cobb angle measurement, and is potentially generalizable to real-world clinical settings.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-03-23T04:16:41Z
  DOI: 10.1177/08465371231163187
Retrospective Comparison of the Lateral-Arm and Vertical Needle Approaches
for Prone Tomosynthesis-Guided Breast Biopsy
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  Authors: Ethan O. Cohen, Olena Weaver, Katrina E. Korhonen, Jia Sun, Jessica W.T. Leung
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-03-22T07:53:26Z
  DOI: 10.1177/08465371231164601
Intra-Specialty Citation Pattern in Radiology and
Gastroenterology/Hepatology Journals: A Cross-Specialty Comparison
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  Authors: Bo Gong, Philippe Soyer, Matthew DF McInnes, Michael N. Patlas
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Objectives: To investigate intra-specialty citation patterns of radiology articles, compared with another medical specialty: gastroenterology/hepatology. Methods: Four radiology journals (Radiology, European Radiology, Diagnostic and Interventional Imaging, Canadian Association of Radiologists Journal) and four gastroenterology/hepatology journals (Journal of Hepatology, Journal of Gastroenterology, World Journal of Gastroenterology, Journal of Clinical Gastroenterology) with similar Web of Science in-category 2020 IF ranking were selected. The original research, review, letter, and editorial articles published in these journals in 2021 were identified. The average number of intra-specialty citations per article (intra-specialty citation count) and percentage of intra-specialty citations out of total citations per article (intra-specialty citation rate) were compared between radiology and gastroenterology/hepatology articles using Student’s t-test. Results: The radiology articles demonstrated a lower total citation count per article (radiology: 29.7 ± .4 (mean ± SEM), n = 2063; gastroenterology/hepatology: 50.1 ± 1.4, n = 1335). The intra-specialty citation count was also lower in radiology articles than gastroenterology/hepatology articles (radiology: 12.9 ± .2, gastroenterology/hepatology: 19.6 ± .7; P < .001), both overall and in all article types. Additionally, the overall intra-specialty citation rate was not significantly different between the two specialties (radiology: 48.8% ± .5%; gastroenterology/hepatology: 47.1 ± .8%; P = .057), although the intra-specialty citation rates were higher in radiology original research and editorial article types. Conclusions: The significantly lower per-article intra-specialty citation counts in all radiology article types, a measurement that directly links to specialty IFs, may contribute to the lower impact factors of radiology journals compared with gastroenterology/hepatology ones.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-03-21T09:40:42Z
  DOI: 10.1177/08465371231163239
Response to Editorial Entitled: Ovarian-Adnexal Reporting and Data System
for Ultrasound: A Framework for Improvement
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  Authors: Catherine H. Phillips, Loretta M. Strachowski, Caroline Reinhold, Rochelle F. Andreotti
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-03-17T05:29:23Z
  DOI: 10.1177/08465371231162630
MI-RADS: An Innovative Mentorship Initiative to Improve Gender Disparity
in Application to Diagnostic Radiology
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  Authors: Alexandra Silver, Helena Bentley, Kathryn E. Darras, Alexandra T. Vertinsky
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-03-11T01:20:00Z
  DOI: 10.1177/08465371231160999
T1 and T2 Mapping for Characterization of Mediastinal Masses: A
Feasibility study
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  Authors: Kyongmin S. Beck, Suyon Chang, Kwanyong Hyun, Yeoun Eun Sung, Kyo-Young Lee, Jung Im Jung
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Purpose: To evaluate the feasibility and usefulness of T1 and T2 mapping in characterization of mediastinal masses. Methods: From August 2019 through December 2021, 47 patients underwent 3.0-T chest MRI with T1 and post-contrast T1 mapping using modified look-locker inversion recovery sequences and T2 mapping using a T2-prepared single-shot shot steady-state free precession technique. Mean native T1, native T2, and post-contrast T1 values were measured by drawing the region of interest in the mediastinal masses, and enhancement index (EI) was calculated using these values. Results: All mapping images were acquired successfully, without significant artifact. There were 25 thymic epithelial tumors (TETs), 3 schwannomas, 6 lymphomas, and 9 thymic cysts, and 4 other cystic tumors. TET, schwannoma, and lymphoma were grouped together as “solid tumor,” to be compared with thymic cysts and other tumors (“cystic tumors”). The mean post-contrast T1 mapping (P < .001), native T2 mapping (P < .001), and EI (P < .001) values showed significant difference between these two groups. Among TETs, high risk TETs (thymoma types B2, B3, and thymic carcinoma) showed significantly higher native T2 mapping values (P = .002) than low risk TETs (thymoma types A, B1, and AB). For all measured variables, interrater reliability was good to excellent (intraclass coefficient [ICC]: .869∼.990) and intrarater reliability was excellent (ICC: .911∼.995). Conclusion: The use of T1 and T2 mapping in MRI of mediastinal masses is feasible and may provide additional information in the evaluation of mediastinal masses.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-03-08T03:39:32Z
  DOI: 10.1177/08465371231160052
Risk Stratification for Oropharyngeal Squamous Cell Carcinoma Using
Texture Analysis on CT – A Step Beyond HPV Status
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  Authors: Yuh-Shin Chang, Jaykumar Raghavan Nair, Connor C. McDougall, Wu Qiu, Robyn Banerjee, Manish Joshi, John T. Lysack
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Background and Purpose: Human papillomavirus-associated oropharyngeal squamous cell carcinoma (OPSCC) is increasingly prevalent. Despite the overall more favorable outcome, the observed heterogeneous treatment response within this patient group highlights the need for additional means to prognosticate and guide clinical decision-making. Promising prediction models using radiomics from primary OPSCC have been derived. However, no model/s using metastatic lymphadenopathy exist to allow prognostication in those instances when the primary tumor is not seen. The aim of our study was to evaluate whether radiomics using metastatic lymphadenopathy allows for the development of a useful risk assessment model comparable to the primary tumor and whether additional knowledge of the HPV status further improves its prognostic efficacy. Materials and Methods: 80 consecutive patients diagnosed with stage III-IV OPSCC between February 2009 and October 2015, known human papillomavirus status, and pre-treatment CT images were retrospectively identified. Manual segmentation of primary tumor and metastatic lymphadenopathy was performed and the extracted texture features were used to develop multivariate assessment models to prognosticate treatment response. Results: Texture analysis of either the primary or metastatic lymphadenopathy from pre-treatment enhanced CT images can be used to develop models for the stratification of treatment outcomes in OPSCC patients. AUCs range from .78 to .85 for the various OPSCC groups tested, indicating high predictive capability of the models. Conclusions: This preliminary study can form the basis multi-centre trial that may help optimize treatment and improve quality of life in patients with OPSCC in the era of personalized medicine.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-03-01T12:05:15Z
  DOI: 10.1177/08465371231157592
Editor’s Corner: August 2023
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  Authors: Jacky C. K. Chow, Michael N. Patlas
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-03-01T03:28:39Z
  DOI: 10.1177/08465371231160893
Competency-Based Medical Education in Radiology – Planning for the
Immediate and Long-Term Future of Radiology Education
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  Authors: Yoan K. Kagoma, Julian Dobranowski, Michael Patlas
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-02-14T11:29:24Z
  DOI: 10.1177/08465371231157252
Corrigendum to “Canadian Radiology Gender Pay Gap-Reality or
Myth'”
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  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-02-01T01:34:43Z
  DOI: 10.1177/07334648221148561
Standardized Reporting on the Preoperative CT Assessment of Potential
Living Renal Transplant Donors: Can We Create a Universal Report Standard
to Meet the Needs of Transplant Urologists'
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  Authors: Hadas Benhabib, Priscila Sacilotto Crivellaro, Heba Osman, Senthujan Gunaseelan, Andrew Chung, Jason Y. Lee, Errol Colak, Vincent Leung, Joseph O’Sullivan, Cynthia Walsh, Ania Kielar
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  Purpose: Determine whether standardized template reporting for the preoperative assessment of potential living renal transplant donors improves the comprehensiveness of radiology reports to meet the needs of urologists performing renal transplants. Methods: Urologist and radiologist stakeholders from renal transplant centers in our province ratified a standardized reporting template for evaluation of potential renal donors. Three centers (A, B, and C) were designated “intervention” groups. Center D was the control group, given employment of a site-specific standardized template prior to study commencement. Up to 100 consecutive CT scan reports per center, pre- and post-implementation of standardized reporting, were evaluated for reporting specific outcome measures. Results: At baseline, all intervention groups demonstrated poor reporting of urologist-desired outcome measures. Center A discussed 5/13 variables (38%), Center B discussed 6/13 variables (46%), and Center C only discussed 1/13 variables (8%) with ≥90% reliability. The control group exhibited consistent reporting, with 11/13 variables (85%) reported at ≥90% reliability. All institutions in the intervention group exhibited excellent compliance to structured reporting post-template implementation (Centers A = 95%, B = 100%, and C = 77%, respectively). Additionally, all intervention centers demonstrated a significant improvement in the comprehensiveness of reports post-template implementation, with statistically significant increases in the reporting of all variables under-reported at baseline (P> .01). Conclusion: Standardized templates across our province for CT scans of potential renal donors promote completeness of reports. Radiologists can reliably provide our surgical colleagues with needed preoperative anatomy and incidental findings, helping to determine suitable transplant donors and reduce potential complications associated with organ retrieval.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-01-31T10:19:07Z
  DOI: 10.1177/08465371231153828
Provision of Culturally Competent Healthcare to Address Healthcare
Disparities
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  Authors: Charlotte J. Yong-Hing, Faisal Khosa
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-01-30T11:44:08Z
  DOI: 10.1177/08465371231154231
Recommendations for the Management of Incidental Musculoskeletal Findings
on MRI and CT
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  Authors: Gina Di Primio, Gordon J. Boyd, Christopher I. Fung, Casey Hurrell, Gary L. Brahm, Jeffery R. Bird, Steven J. Co, Iain D. C. Kirkpatrick
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  The Canadian Association of Radiologists (CAR) Incidental Findings Working Group consists of both academic subspeciality and general radiologists tasked with either adapting American College of Radiology (ACR) guidelines to meet the needs of Canadian radiologists or authoring new guidelines where appropriate. In this case, entirely new guidelines to deal with incidental musculoskeletal findings that may be encountered on thoracoabdominal computed tomography or magnetic resonance imaging were drafted, focussing on which findings should prompt recommendations for further workup. These recommendations discuss how to deal with incidental marrow changes, focal bone lesions, abnormalities of the pubic symphysis and sacroiliac joints, fatty soft tissue masses, manifestations of renal osteodystrophy and finally discuss opportunistic osteoporosis evaluation.
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-01-30T07:08:32Z
  DOI: 10.1177/08465371231152151
The Role of Computed Tomography and Magnetic Resonance Imaging in Accurate
Size Estimation of Pancreatic Ductal Adenocarcinoma
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  Authors: Mostafa Alabousi, Michael N. Patlas
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-01-19T05:28:11Z
  DOI: 10.1177/08465371231153030
Applications of Artificial Intelligence in Urological Oncology Imaging:
More Data Are Needed
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  Authors: Philippe Soyer, Anthony Dohan, Maxime Barat
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-01-11T08:31:41Z
  DOI: 10.1177/08465371231152230
Learning Radiology AI Concepts by Seeing and Doing
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  Authors: Bo Gong, Michael N. Patlas
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-01-09T03:26:08Z
  DOI: 10.1177/08465371231151239
Screening with Breast Cancer Mammography: Re-Evaluation of Current
Evidence
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  Authors: Jean-Paul Salameh, Mohammed Kashif Al-Ghita, Matthew D. F. McInnes, Jean M. Seely
  Abstract: Canadian Association of Radiologists Journal, Ahead of Print.
  
  Citation: Canadian Association of Radiologists Journal
  PubDate: 2023-01-02T01:46:29Z
  DOI: 10.1177/08465371221148134