A Pilot of Data-Driven Modeling to Assess Potential for Improved Efficiency in an Academic Breast-Imaging Center.

Patient satisfaction and department efficiency are central pillars in defining quality in medicine. Patient satisfaction is often linked to wait times. We describe a novel method to study workflow and simulate solutions to improve efficiency, thereby decreasing wait times and adding value.

Variability in Individual Radiologist BI-RADS 3 Usage at a Large Academic Center: What's the Cause and What Should We Do About It?

Rationale And Objectives: Although the breast imaging reporting and data system (BI-RADS) lists specific criteria for designating a lesion as BI-RADS category 3 (probably benign), there are no target benchmarks for BI-RADS 3 usage rates. This study investigates the variability of BI-RADS 3 rates among a group of academic breast imagers, with the goal of defining more precise utilization.

Materials And Methods: We retrospectively reviewed all diagnostic mammograms performed between July 1, 2013 and August 8, 2017 at our academic institution.

The fate of radiology report recommendations at a pediatric medical center.

Background: The American College of Radiology (ACR) practice parameters for communication dictate that follow-up recommendations be suggested when appropriate. Radiologists assume that referring physicians read their reports and heed their advice. In reality, recommendations might not be carried out or even acknowledged.

Black Toenail Sign in MELAS Syndrome.

Background: Mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome is a mitochondrial disorder often causing progressive brain injury that is not confined to large arterial territories. Severe insults ultimately lead to gyral necrosis affecting the cortex and juxtacortical white matter; the neuroimaging correlate is partial gyral signal suppression on T2/FLAIR sequences that resemble black toenails. We aimed to characterize the imaging features and the natural history of MELAS-related gyral necrosis.

Breaking Bad News: A Survey of Radiology Residents' Experiences Communicating Results to Patients.

Purpose: The practice of radiology often includes routine communication of diagnostic test results directly to patients in breast imaging and interventional radiology. There is increasing interest in expanding direct communication throughout radiology. Though these conversations can substantially affect patient well-being, there is limited evidence indicating that radiology residents are specifically taught methods to effectively convey imaging results to patients.

Reduced subarachnoid fluid diffusion in enlarged subarachnoid spaces of infancy.

Background and purpose Enlargement of the subarachnoid spaces in infancy (ESSI) is a common cause of macrocephaly without proven explanation. We have observed subarachnoid diffusion to be decreased in these patients. We aim to quantify the diffusivity of ventricular and subarachnoid cerebrospinal fluid in ESSI patients, to determine if diffusion characteristics deviate from normocephalic infants, and to propose a unique mechanism for ESSI.

Radiology Reports: What YOU Think You're Saying and What THEY Think You're Saying.

Background: Image interpretation and translation into written language is an imperfect process. Yet, the radiology report represents the link between radiologist's opinion and patient's images. Increased access to images through remote viewing stations has made direct communication between radiologists and clinicians less commonplace.

An Abbreviated Protocol for High-Risk Screening Breast MRI Saves Time and Resources.

Purpose: To review the ability of an abbreviated, high-risk, screening, breast MRI protocol to detect cancer and save resources.

Methods: High-risk screening breast MR images were reviewed, from both an abbreviated protocol and a full diagnostic protocol. Differences in cancer detection, scanner utilization, interpretation times, and need for additional imaging were recorded in an integrated data form, and reviewed and compared.

Lesional perfusion abnormalities in Leigh disease demonstrated by arterial spin labeling correlate with disease activity.

Background: Leigh disease is a metabolic disorder of the mitochondrial respiratory chain culminating in symmetrical necrotizing lesions in the deep gray nuclei or brainstem. Apart from classic gliotic/necrotic lesions, small-vessel proliferation is also characteristic on histopathology. We have observed lesional hyperperfusion on arterial spin-labeling (ASL) sequence in children with Leigh disease.

An Abbreviated Protocol for High-Risk Screening Breast MRI Saves Time and Resources.

Purpose: To review the ability of an abbreviated, high-risk, screening, breast MRI protocol to detect cancer and save resources.

Methods: High-risk screening breast MR images were reviewed, from both an abbreviated protocol and a full diagnostic protocol. Differences in cancer detection, scanner utilization, interpretation times, and need for additional imaging were recorded in an integrated data form, and reviewed and compared.

Neuroimaging Features of San Luis Valley Syndrome.

A 14-month-old Hispanic female with a history of double-outlet right ventricle and developmental delay in the setting of recombinant chromosome 8 syndrome was referred for neurologic imaging. Brain MR revealed multiple abnormalities primarily affecting midline structures, including commissural dysgenesis, vermian and brainstem hypoplasia/dysplasia, an interhypothalamic adhesion, and an epidermoid between the frontal lobes that enlarged over time. Spine MR demonstrated hypoplastic C1 and C2 posterior elements, scoliosis, and a borderline low conus medullaris position.

Incidental lung cancer found on screening breast MRI with eventual lymphatic metastasis to the breast.

A 49 year-old female underwent breast MRI for further evaluation of a single projection mammographic finding. MR showed normal breast tissue; however, a 3 cm right lung mass was incidentally discovered, and later confirmed by chest CT. Four years after upper lobectomy, lymphadenectomy, and chemoradiation for stage IIIA non-small cell lung cancer, she presented with a breast rash.

Metastatic Disease to the Breast From Extramammary Malignancies: A Multimodality Pictorial Review.

This pictorial review demonstrates imaging features of extramammary malignancies metastatic to the breast seen with multiple modalities, including mammography, ultrasound, computed tomography (CT), positron emission tomography, and magnetic resonance imaging. Although rare, metastases to the breast may have a distinct imaging appearance from the appearance of primary breast cancers. They are important to identify because they can mimic benign breast disease and their treatment differs from that of primary breast cancer.

Various causes for frontal sinus obstruction.

Purpose: A variety of inflammatory and structural conditions can cause frontal sinusitis. The present study was conducted as pilot study to determine the primary cause of frontal sinusitis at the time of endoscopic sinus surgery.

Materials And Methods: Retrospective chart review was performed from 1997 to 2004 of patients who underwent endoscopic frontal sinus surgery at the University of Virginia.