Augmenting inter-rater concordance of radiologic extranodal extension in HPV-positive oropharyngeal carcinoma: A multicenter study.

Objectives: To assess intra- and inter-institutional concordance and identify methods to increase precision in radiologic extranodal extension (rENE) ascertainment in HPV+ oropharyngeal carcinoma.

Methods: Six radiologists, blinded to clinical outcomes, from three centers assessed rENE in two phases: Phase-I (20 cases) utilized each individual's a priori appreciation of the literature. Phase-II (30 additional cases) was performed after deliberating experience and consolidating operating definitions.

Radiologic-pathologic correlation of major versus minor extranodal extension in oral cavity cancer.

Background: To evaluate the diagnostic performance of radiologic extranodal extension (rENE) in predicting major (>2 mm) and minor (≤2 mm) pathologic ENE (pENE).

Methods: All oral cavity squamous cell carcinoma patients who underwent neck dissection with pathological nodal disease (pN+) between 2010 and 2015 were reviewed. Preoperative computed tomography and/or magnetic resonance imaging were reviewed by two head and neck neuroradiologists.

Inter-rater concordance and operating definitions of radiologic nodal feature assessment in human papillomavirus-positive oropharyngeal carcinoma.

Background And Purpose: This study aims to evaluate the reliability of radiologic nodal feature assessment in clinical node-positive human papillomavirus-positive oropharyngeal carcinoma.

Materials And Methods: Baseline CTs or MRIs of clinical node-positive human papillomavirus-positive oropharyngeal carcinoma diagnosed between 2012 and 2015 were reviewed independently by two neuroradiologists for seven nodal features: radiologic nodal involvement, cystic change, presence of necrosis, clustering, conglomeration, coalescence, and extranodal extension. Consensus operating definitions were derived after discussion.

Prognostic value of clinical and radiologic extranodal extension and their role in the 8th edition TNM cN classification for HPV-negative oropharyngeal carcinoma.

Background/objectives: We evaluate the performance between the TNM-8 versus TNM-7 cN-classification and explore the relative prognostic contribution of radiologic extranodal extension (rENE) for HPV-negative oropharyngeal cancer (HPV-OPC).

Materials/methods: All HPV- OPC treated with IMRT between 2005 and 2016 were included. cENE was defined as unambiguous "fixation" of a neck mass or "skin involvement" on clinical examination.

Cryptogenic cervical intramedullary abscess with rapidly progressive myelopathy: illustrative case.

Background: The purpose of the present case report is to highlight the presentation, workup, clinical decision making, and operative intervention for a 68-year-old woman who developed rapidly progressive myelopathy secondary to idiopathic cervical intramedullary abscess.

Observations: The patient underwent laminectomy and aspiration/biopsy of the lesion. Intraoperatively, division of the posterior median sulcus released a large volume of purulent material growing the oral pathogens Eikenella corrodens and Gemella morbillorum.

Lessons Learned From the Effects of COVID-19 on the Training and Education Workflow of Radiology Residents-A Time for Reflection: Perspectives of Residency Program Directors and Residents in Canada.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has led to widespread changes in all health care settings including academic radiology departments. The purpose of this survey-based study was to investigate the impact of COVID-19 on radiology resident training and education workflow in Canada in terms of the nature, scale, and heterogeneity of the changes, preparedness and adaptation, and perceptions of the present and future of radiology training.

Methods: A 30-question web-based survey was sent to 17 radiology residency program directors across Canada.

Pre- and Post-Radiotherapy Radiologic Nodal Features and Oropharyngeal Cancer Outcomes.

Objectives: To assess the prognostic value of pre-/post-radiotherapy (pre-/post-RT) radiologic lymph node (LN) features in human papillomavirus (HPV)-positive and HPV-negative oropharyngeal carcinoma (OPC) patients treated with definitive (chemo-)RT.

Methods: Clinical node-positive OPCs treated from 2011 to 2015 were reviewed. Nodal features were reviewed by a radiologist on pre-/post-RT computed tomography (CTs).

Optimising after-hours workflow of computed tomography orders in the emergency department.

Ordering and protocolling CT scans after-hours from the emergency department (ED) at our institution previously required discussion between the ED physician and radiology resident, which led to workflow inefficiency. Our intervention consisted of creating an electronic list of CT requests that radiology residents would monitor. Radiology protocolled straightforward requests and contacted the ordering physician for more details when required.

Prognostic importance of radiologic extranodal extension in HPV-positive oropharyngeal carcinoma and its potential role in refining TNM-8 cN-classification.

Purpose: This study examines outcome heterogeneity and potential to refine the TNM-8 cN-classification using radiologic extranodal extension (rENE) in a contemporary HPV-positive (HPV+) oropharyngeal carcinoma (OPC) cohort.

Methods: All HPV+ OPC treated with definitive IMRT from 2010-2015 were included. Pre-treatment CT/MR of cN+ cases were reviewed by a head-neck radiologist for rENE.

Radiologic Extranodal Extension Portends Worse Outcome in cN+ TNM-8 Stage I Human Papillomavirus-Mediated Oropharyngeal Cancer.

Purpose: To identify adverse radiologic nodal features in cN+ TNM-8 stage I human papillomavirus-related (HPV+) oropharyngeal cancer (OPC).

Methods And Materials: All patients with HPV+ cT1-T2cN1 OPC treated with definitive intensity modulated radiation therapy from 2008 to 2015 were included. Radiologically involved lymph node number (LN), radiologic extranodal extension (rENE), retropharyngeal LN (RPLN), and lower neck (level 4 or 5b) LN involvement were assessed on pre-treatment computed tomography/magnetic resonance imaging by a specialized head and neck neuroradiologist.

Assessing Competence in Emergency Radiology Using an Online Simulator.

Rationale And Objectives: Traditional assessments in radiology residency focus on the Medical Expert CanMEDS role and typically rely upon a single or limited static images. We designed an Emergency Radiology Simulator that aimed to assess the breadth of competencies required across Medical and NonMedical Expert domains.

Material And Methods: An online simulator with typical emergency cases was administered in October 2015 to Post Graduate Year (PGY) 2-5 residents in Radiology.

Morphologic and topographic radiologic features of human papillomavirus-related and -unrelated oropharyngeal carcinoma.

Background: The purpose of this study was to compare the clinicoradiologic characteristics of human papillomavirus (HPV)-related (HPV-positive) and HPV-unrelated (HPV-negative) oropharyngeal carcinoma (OPC).

Methods: Primary tumor and lymph node features of HPV-positive and HPV-negative OPCs from 2008 to 2013 were compared on pretreatment CT/MRI. Intrarater/interrater concordance was assessed.

Imaging of auriculotemporal nerve perineural spread.

Importance: Adenoid cystic carcinomas (ACCs) are relatively rare tumours, notorious for wide local infiltration and perineural spread. Perineural extension commonly occurs along branches of the trigeminal and facial nerves, and its presence represents a poor prognostic factor with implications for treatment approach.

Observations: We report the case of a 61-year-old female presenting with worsening left facial numbness and weakness.

Can axial-based nodal size criteria be used in other imaging planes to accurately determine "enlarged" head and neck lymph nodes?

Objective. We evaluate if axial-based lymph node size criteria can be applied to coronal and sagittal planes. Methods.

Parotid gland metastasis originating from malignant meningioma.

A case of malignant meningioma with metastasis to the parotid gland is reported. A 60-year-old woman with right-sided neurological symptoms secondary to malignant meningioma developed bilateral parotid masses with identical histology to the primary lesion. The primary lesion was differentiated from a benign oligodendroma with MRI, and the radiological features of this extraordinarily rare metastasis are chronicled with MRI and computed tomography.

Union and bone resorption of free fibular flaps in mandibular reconstruction.

Background: The purpose of this study was to evaluate bony union and resorption after free fibular flap reconstruction for mandibular reconstruction.

Methods: A total of 112 patients with composite resection and reconstruction with a fibular free flap were included. Computed tomography scan images taken after the reconstruction and approximately 1 year postoperatively were assessed to evaluate union (n = 60) and bone resorption (n = 24) of the neomandible.

Imaging and resectability issues of sinonasal tumors.

Sinonasal tumors can invade into the critical structures of the anterior and central skull base. Although the determination of precise tumor histology is difficult with imaging, radiology is important in helping differentiate malignant from benign disease. Imaging helps to map the anatomical extent of intracranial and intraorbital tumor, which has important implications for staging, treatment and prognosis.

Suprasellar non-Langerhans cell histiocytosis (Erdheim-Chester disease)--a case report.

Erdheim-Chester disease (ECD) is an uncommon non-Langerhans cell histiocytosis that affects multiple body systems and can present clinically in a myriad of ways. An adult onset is most common with bony involvement and constitutional symptoms. We report the case of a 52-year-old female presenting with diabetes insipidus and a suprasellar mass on imaging, with no evidence of extracerebral involvement.

Factors involved in discrepant preliminary radiology resident interpretations of neuroradiological imaging studies: a retrospective analysis.

Objective: The purpose of this article is to determine discrepancy rates in radiology residents' interpretations of CT and MRI studies of the head, neck, and spine and to attempt to quantify its potential or realized effect on patient care. Secondarily, we attempted to determine the effect of resident, study, and patient variables on discrepancy rate.

Materials And Methods: A retrospective review of all relevant studies from March 1, 2009, through December 31, 2009, revealed 5695 cases with preliminary interpretations made by on-call residents.

NASCET percent stenosis semi-automated versus manual measurement on CTA.

Purpose: To compare North American Symptomatic Carotid Endarterectomy Trial (NASCET) stenosis values and NASCET grade categorization (mild, moderate, severe) of semi-automated vessel analysis software versus manual measurements on computed tomography angiography (CTA).

Methods: There were four observers. Two independently analyzed 81 carotid artery CTAs using semi-automated vessel analysis software according to a blinded protocol.