Designing Clinical MRI for Enhanced Workflow and Value.

MRI is an expensive and traditionally time-intensive modality in imaging. With the paradigm shift toward value-based healthcare, radiology departments must examine the entire MRI process cycle to identify opportunities to optimize efficiency and enhance value for patients. Digital tools such as "frictionless scheduling" prioritize patient preference and convenience, thereby delivering patient-centered care.

Deep Learning Diagnosis and Classification of Rotator Cuff Tears on Shoulder MRI.

Background: Detection of rotator cuff tears, a common cause of shoulder disability, can be time-consuming and subject to reader variability. Deep learning (DL) has the potential to increase radiologist accuracy and consistency.

Purpose: The aim of this study was to develop a prototype DL model for detection and classification of rotator cuff tears on shoulder magnetic resonance imaging into no tear, partial-thickness tear, or full-thickness tear.

Deep Learning Reconstruction Enables Prospectively Accelerated Clinical Knee MRI.

Background MRI is a powerful diagnostic tool with a long acquisition time. Recently, deep learning (DL) methods have provided accelerated high-quality image reconstructions from undersampled data, but it is unclear if DL image reconstruction can be reliably translated to everyday clinical practice. Purpose To determine the diagnostic equivalence of prospectively accelerated DL-reconstructed knee MRI compared with conventional accelerated MRI for evaluating internal derangement of the knee in a clinical setting.

Artificial Intelligence-Driven Ultra-Fast Superresolution MRI: 10-Fold Accelerated Musculoskeletal Turbo Spin Echo MRI Within Reach.

Magnetic resonance imaging (MRI) is the keystone of modern musculoskeletal imaging; however, long pulse sequence acquisition times may restrict patient tolerability and access. Advances in MRI scanners, coil technology, and innovative pulse sequence acceleration methods enable 4-fold turbo spin echo pulse sequence acceleration in clinical practice; however, at this speed, conventional image reconstruction approaches the signal-to-noise limits of temporal, spatial, and contrast resolution. Novel deep learning image reconstruction methods can minimize signal-to-noise interdependencies to better advantage than conventional image reconstruction, leading to unparalleled gains in image speed and quality when combined with parallel imaging and simultaneous multislice acquisition.

New-Generation Low-Field Magnetic Resonance Imaging of Hip Arthroplasty Implants Using Slice Encoding for Metal Artifact Correction: First In Vitro Experience at 0.55 T and Comparison With 1.5 T.

Objectives: Despite significant progress, artifact-free visualization of the bone and soft tissues around hip arthroplasty implants remains an unmet clinical need. New-generation low-field magnetic resonance imaging (MRI) systems now include slice encoding for metal artifact correction (SEMAC), which may result in smaller metallic artifacts and better image quality than standard-of-care 1.5 T MRI.

Anterior Shoulder Instability in the Aging Population: MRI Injury Pattern and Management.

Literature on glenohumeral dislocations has focused on younger patient populations because of high recurrence rates. However, the spectrum of injuries sustained in younger versus older patient populations is reported to be quite different. The purpose of this article is to describe MRI findings and management of anterior shoulder instability in the aging (≥ 60 years) population.

Using Deep Learning to Accelerate Knee MRI at 3 T: Results of an Interchangeability Study.

Deep learning (DL) image reconstruction has the potential to disrupt the current state of MRI by significantly decreasing the time required for MRI examinations. Our goal was to use DL to accelerate MRI to allow a 5-minute comprehensive examination of the knee without compromising image quality or diagnostic accuracy. A DL model for image reconstruction using a variational network was optimized.

Artificial Intelligence for MR Image Reconstruction: An Overview for Clinicians.

Artificial intelligence (AI) shows tremendous promise in the field of medical imaging, with recent breakthroughs applying deep-learning models for data acquisition, classification problems, segmentation, image synthesis, and image reconstruction. With an eye towards clinical applications, we summarize the active field of deep-learning-based MR image reconstruction. We review the basic concepts of how deep-learning algorithms aid in the transformation of raw k-space data to image data, and specifically examine accelerated imaging and artifact suppression.

Pattern Recognition in Musculoskeletal Imaging Using Artificial Intelligence.

Artificial intelligence (AI) has the potential to affect every step of the radiology workflow, but the AI application that has received the most press in recent years is image interpretation, with numerous articles describing how AI can help detect and characterize abnormalities as well as monitor disease response. Many AI-based image interpretation tasks for musculoskeletal (MSK) pathologies have been studied, including the diagnosis of bone tumors, detection of osseous metastases, assessment of bone age, identification of fractures, and detection and grading of osteoarthritis. This article explores the applications of AI for image interpretation of MSK pathologies.

Supraspinatus muscle shear wave elastography (SWE): detection of biomechanical differences with varying tendon quality prior to gray-scale morphologic changes.

Objective: The purpose of this study was to determine whether SWE can detect biomechanical changes in the supraspinatus muscle that occur with increasing supraspinatus tendon abnormality prior to morphologic gray-scale changes.

Materials And Methods: An IRB approved, HIPAA compliant retrospective study of shoulder ultrasounds from 2013-2018 was performed. The cohort consisted of 88 patients (mean age 55 ± 15 years old) with 110 ultrasounds.

Anteroposterior Radiograph of the Ankle with Cross-Sectional Imaging Correlation.

The focus of this article is to illustrate various pathologic entities and variants, heralding disease about the ankle, based on scrutiny of AP radiographs of the ankle, with correlative findings on cross-sectional imaging. Many of these entities can only be detected on the AP ankle radiograph and, if not recognized, may lead to delayed diagnosis and persistent morbidity to the patient. However, a vigilant radiologist, equipped with the knowledge of the characteristic appearance and typical locations of the imaging findings, should be able to make the crucial initial diagnosis and surmise additional findings to be confirmed on cross-sectional imaging.

Improving Emergency Department Flow: Reducing Turnaround Time for Emergent CT Scans.

Emergency departments across the U.S. are more congested than ever, and there is a pressing need to create capacity by improving patient flow.

Ulnar Collateral Ligament Insertional Injuries in Pediatric Overhead Athletes: Are MRI Findings Predictive of Symptoms or Need for Surgery?

Objective: The purpose of this study was to determine whether ulnar collateral ligament (UCL) insertion below the articular margin (so-called T sign) exists in the pediatric population and whether MRI features can be used to identify insertional UCL injuries in overhead athletes that are symptomatic or require surgery.

Materials And Methods: Retrospective review of elbow MR images of patients younger than 21 years from 2011 to 2017 yielded 26 control subjects who were not overhead athletes and 97 overhead athletes. According to the clinical diagnosis, 50 of the overhead athletes had symptoms.

Shoulder Injuries in the Overhead-Throwing Athlete: Epidemiology, Mechanisms of Injury, and Imaging Findings.

The unparalleled velocity achieved by overhead throwers subjects the shoulder to extreme forces, resulting in both adaptive changes and pathologic findings that can be detected at imaging. A key biomechanical principle of throwing is achieving maximum external rotation, which initially leads to adaptive changes that may result in a pathologic cascade of injuries. In addition to the well-established concepts of glenohumeral internal rotation deficit and internal impingement, osseous and soft-tissue injuries of the shoulder unique to overhead athletes are illustrated.

Adventures and Misadventures in Plastic Surgery and Soft-Tissue Implants.

Soft-tissue augmentation and implants are increasingly seen by the radiologist as more techniques emerge for a variety of indications and locations. Some surgical and implant procedures are performed for purely cosmetic reasons in otherwise healthy patients seeking to improve their body image, and some are performed for reconstruction after cancer or other chronic illnesses. Abdominoplasty, liposuction, and autologous fat grafting can be performed for abdominal and gluteal contouring.

Elbow Injuries in Pediatric Overhead Athletes.

Objective: The purpose of this article is to discuss common elbow injuries found in pediatric athletes who participate in sports that entail overhead movements with focus on mechanism, clinical features, imaging appearance, and treatment options.

Conclusion: Elbow injuries are commonly seen in pediatric overhead athletes and have been on the rise owing to the increased participation in and demand of youth sports. Imaging plays a critical role in identifying the type and severity of injury, which helps to determine appropriate treatment options.

Elbow Injuries in Adult Overhead Athletes.

Objective: The purpose of this article is to review common elbow injuries found in overhead athletes with focus on mechanism, clinical features, imaging appearance, and treatment options.

Conclusion: The overhead throwing motion subjects the elbow to a variety of complex forces, which places both osseous and soft-tissue structures at high risk for injury.

Shoulder Arthroplasty, from Indications to Complications: What the Radiologist Needs to Know.

The replaced shoulder is increasingly encountered by the radiologist, both on a dedicated and incidental basis, in this era of the growing population of aging patients wishing to preserve their mobility and function. Knowledge of the normal biomechanics of the glenohumeral joint-particularly the function of the rotator cuff and the unique relationship of the humeral head to the glenoid-is essential for understanding the need for shoulder replacement and its subsequent complications, because the intent of shoulder arthroplasty is to approximate the normal joint as closely as possible. The most common indications for shoulder arthroplasty are osteoarthritis, inflammatory arthritis, proximal humerus fractures, irreparable rotator cuff tears, rotator cuff arthropathy, and avascular necrosis of the humeral head.

Radiology ExamWeb: development and implementation of a national web-based examination system for medical students in radiology.

Rationale And Objectives: Faculty are often limited in time, knowledge, and resources to develop efficient, effective, and valid computer-based examinations to evaluate students. Our purpose was to develop a web-based pool of standardized National Board of Medical Examiners (NBME)-format, peer-reviewed, and peer-tested questions based on the Alliance of Medical Student Educators in Radiology (AMSER) National Medical Student Curriculum to evaluate the radiologic knowledge of medical students.

Materials And Methods: Members of the AMSER Electronics Committee submitted questions they had written for their institutions and later developed a 113-question standardized examination.

Multidisciplinary approach to diagnosis and management of intraductal papillary mucinous neoplasms of the pancreas.

Intraductal papillary mucinous neoplasms have gained recognition in recent years as premalignant precursors to pancreatic cancer that enable early detection and often are found incidentally at imaging. Accurate diagnosis and optimal, finely tuned management of these lesions are important and require collaboration across various disciplines, including radiology, endoscopy, surgery, and pathology. Several imaging modalities can visualize these lesions adequately, each with specific advantages and disadvantages.