Radiology

Gray Matter Structural Network Disruptions in Survivors of Acute Lymphoblastic Leukemia with Chemotherapy Treatment Publication date: Available online 4 June 2019 Source: Academic Radiology Author(s): Longsheng Wang, Liwei Zou, Qi Chen, Lianzi Su, Jiajia Xu, Ru Zhao, Yanqi Shan, Qing Zhang, Zhimin Zhai, Xijun Gong, Hong Zhao, Fangbiao Tao, Suisheng Zheng Objectives Neuroimaging studies of acute lymphoblastic leukemia (ALL) during chemotherapy treatment have shown alterations in structure, function, and connectivity in several brain regions, suggesting neurobiological impairment that might influence the large-scale brain network. This study aimed to detect the alterations in the topological organization of structural covariance networks of ALL patients. Methods This study included 28 ALL patients undergoing chemotherapy and 20 matched healthy controls. We calculated the gray matter volume of 90 brain regions based on an automated anatomical labeling template and applied graph theoretical analysis to compare the topological parameters of the gray matter structural networks between the two groups. Results The results demonstrated that both the ALL and healthy control groups exhibited a small-world topology across the range of densities. Compared to healthy controls, ALL patients had less highly interactive nodes and a reduced degree/betweenness in temporal regions, which may contribute to impaired memory and executive functions in these patients. Conclusion These results reveal that ALL patients undergoing chemotherapy treatment may have decreased regional connectivity and reduced efficiency of their structural covariance network. This is the first report of anomalous large-scale gray matter structural networks in ALL patients undergoing chemotherapy treatment and provides new insights regarding the neurobiological mechanisms underlying the chemo-brain network.

Developing an Education Budget for Radiology Vice Chairs and Leaders: An ADVICER Template Publication date: Available online 3 June 2019 Source: Academic Radiology Author(s): Nancy R. Fefferman, Sheryl G. Jordan, Priscilla J. Slanetz, Desiree E. Morgan, Leonie L. Gordon, Robert D. Suh, Mark E. Mullins Rationale and Objectives The Alliance of Directors and Vice Chairs in Education group identified the need to develop an education budget template as resource for our community. Having a framework and working knowledge of budgetary considerations is crucial to those with general oversight and executive managerial responsibility for departmental educational programs. Methods An online survey was sent to all the Alliance of Directors and Vice Chairs in Education members. Survey questions included education funding sources, presence of vice chair of finance, expectation of revenue generation, existing education budget, funding decision-makers, education budget formulation and approval, vice chair of education's role in budget, education budget line items, and income statement review. Results The survey response rate was 41/81 (51%). A majority 26/41 (63%) of respondents had an education budget that typically included funding for all medical students, residents, and fellows but only a minority of respondents report they developed 10/22 (45%), approved 6/22 (27%), or regularly reviewed 6/21 (29%) this budget. In sharp contrast was the role of department chairs and administrators, who presumably all participated in this process. To assist in education budget development and review, as well as meet the need to improve participants' financial accounting knowledge as a key tenet of faculty professional development, the authors developed sample budget templates and an income statement primer. Conclusion Our survey results suggested the need for an educational budget framework and financial accounting resources for those in radiology education posts, and resources have been provided.

The Resident Travel Dilemma Publication date: June 2019 Source: Academic Radiology, Volume 26, Issue 6 Author(s): Cory M. Pfeifer

The Importance of Learning to Listen Publication date: June 2019 Source: Academic Radiology, Volume 26, Issue 6 Author(s): Richard B. Gunderman

Automated Test-Item Generation System for Retrieval Practice in Radiology Education Publication date: June 2019 Source: Academic Radiology, Volume 26, Issue 6 Author(s): Gowthaman Gunabushanam, Caroline R. Taylor, Mahan Mathur, Jamal Bokhari, Leslie M. Scoutt Objective To develop and disseminate an automated item generation (AIG) system for retrieval practice (self-testing) in radiology and to obtain trainee feedback on its educational utility. Materials and Methods An AIG software program (Radmatic) that is capable of generating large numbers of distinct multiple-choice self-testing items from a given "item-model" was created. Instead of writing multiple individual self-testing items, an educator creates an "item-model" for one of two distinct item styles: true/false knowledge based items and image-based items. The software program then uses the item model to generate self-testing items upon trainee request. This internet-based system was made available to all radiology residents at our institution in conjunction with our didactic conferences. After obtaining institutional review board approval and informed consent, a written survey was conducted to obtain trainee feedback. Results Two faculty members with no computer programming experience were able to create item-models using a standard template. Twenty five of 54 (46%) radiology residents at our institution participated in the study. Twelve of these 25 (48%) study participants reported using the self-testing items regularly, which correlated well with the anonymous website usage statistics. The residents' overall impression and satisfaction with the self-testing items was quite positive, with a score of 7.89 ± 1.91 (mean ± SD) out of 10. Lack of time and email overload were the main reasons provided by residents for not using self-testing items. Conclusion AIG enabled self-testing is technically feasible, and is perceived positively by radiology residents as useful to their education.

Patient-Centered and Specialty-Specific Case Work-Up: An Effective Method for Teaching Appropriateness of Imaging to Medical Students Publication date: June 2019 Source: Academic Radiology, Volume 26, Issue 6 Author(s): Mike Sheng, Preya Shah, John M. Choi, Eleanor Gillis, Sharyn I. Katz, Scott A. Simpson, Sean H. Novak, Arun C. Nachiappan Rationale and Objectives Our institution has developed a mini-course program within the diagnostic radiology elective curriculum that promotes active learning, using patient cases specifically tailored to students' future specialties. The purpose of this study is to evaluate the effectiveness of this mini-course on medical student knowledge of imaging appropriateness and attitude toward radiologist consultation. Materials and Methods During each month-long radiology elective course, students were divided into teams of up to four students based on their specialty interest and assigned recent patient cases with imaging findings relevant to their specialties. The students researched their customized patient cases, integrated pertinent clinical and imaging findings, and presented their findings in a final preceptor-led session. A five-point Likert-type item preprogram and postprogram survey assessing knowledge of imaging appropriateness and attitude toward radiologist consultation was sent to the enrolled medical students. Results Out of 36 medical students, 33 (92%) completed the preprogram survey and 31 (86%) completed the postprogram survey. Students reported improved confidence in knowledge of imaging appropriateness, such as indications for intravenous contrast (p < 0.0005) and oral contrast (p < 0.0005). Furthermore, students reported an improved understanding of how to utilize radiologists (p < 0.005) and how to provide pertinent clinical historical information when requesting a radiology exam (p < 0.0005). Students reported that researching the patient's historical and clinical information in conjunction with the radiology images made them more invested in the case. Conclusion Assigning customized patient cases to medical students on diagnostic radiology elective, tailored to their future specialties, is an effective and active way to teach imaging appropriateness and to improve attitudes toward radiologist consultation.

Perceptual and Interpretive Error in Diagnostic Radiology—Causes and Potential Solutions Publication date: June 2019 Source: Academic Radiology, Volume 26, Issue 6 Author(s): Andrew J. Degnan, Emily H. Ghobadi, Peter Hardy, Elizabeth Krupinski, Elena P. Scali, Lindsay Stratchko, Adam Ulano, Eric Walker, Ashish P. Wasnik, William F. Auffermann Interpretation of increasingly complex imaging studies involves multiple intricate tasks requiring visual evaluation, cognitive processing, and decision-making. At each stage of this process, there are opportunities for error due to human factors including perceptual and ergonomic conditions. Investigation into the root causes of interpretive error in radiology first began over a century ago. In more recent work, there has been increasing recognition of the limits of human image perception and other human factors and greater acknowledgement of the role of the radiologist's environment in increasing the risk of error. This article reviews the state of research on perceptual and interpretive error in radiology. This article focuses on avenues for further error examination, and strategies for mitigating these errors are discussed. The relationship between artificial intelligence and interpretive error is also considered.

Forensic Radiology: An Exciting and Developing Field That Needs More Trained Radiologists Publication date: June 2019 Source: Academic Radiology, Volume 26, Issue 6 Author(s): Barry Daly

Forensic Radiology: A Primer Publication date: June 2019 Source: Academic Radiology, Volume 26, Issue 6 Author(s): Summer J. Decker, Maria Braileanu, Courtney Dey, Leon Lenchik, Michael Pickup, Jason Powell, Maria Tucker, Linda Probyn Rationale and objective: Forensic radiology is a relatively unknown subspecialty which is becoming increasingly more important. The field incorporates antemortem and postmortem imaging for the detection and documentation of various pathologies for medicolegal purposes. Postmortem imaging is increasingly used in conjunction with the traditional autopsy in a process called a "virtual" autopsy. Radiography has been a staple of forensic investigations for over a century, first used in 1896. Advanced imaging techniques such as postmortem computed tomography and postmortem magnetic resonance imaging have only recently gained acceptance in the forensic science community. Postmortem computed tomography and postmortem magnetic resonance imaging methods are now widely used in some parts of the world, while other countries including the United States have been slower to adopt these methods into their daily practice. Advanced forensic imaging is increasingly used in the courts where juries have responded positively to such presentation of forensic data. For these reasons, advanced postmortem imaging is becoming a regular part of forensic investigations. The increase in the use of forensic imaging presents a unique opportunity for radiologists to collaborate with pathologists and law enforcement officials. This paper provides an overview of forensic radiology and identifies potential challenges and opportunities.

A Review of Options for Localization of Axillary Lymph Nodes in the Treatment of Invasive Breast Cancer Publication date: June 2019 Source: Academic Radiology, Volume 26, Issue 6 Author(s): Ryan W. Woods, Melissa S. Camp, Nicholas J. Durr, Susan C. Harvey Invasive breast cancer is a common disease, and the most common initial site of metastatic disease are the axillary lymph nodes. As the standard of care shifts towards less invasive surgery in the axilla for patients with invasive breast cancer, techniques have been developed for axillary node localization that allow targeted dissection of specific lymph nodes without requiring full axillary lymph node dissection. Many of these techniques have been adapted from technologies developed for localization of lesions within the breast and include marker clip placement with intraoperative ultrasound, carbon-suspension liquids, localization wires, radioactive seeds, magnetic seeds, radar reflectors, and radiofrequency identification devices.The purpose of this article is to summarize these methods and describe benefits and drawbacks of each method for performing localization of lymph nodes in the axilla.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com