Factors Driving Resistance to Clinical Decision Support: Finding Inspiration in Radiology 3.0.

Purpose: The effectiveness of evidence-based guidelines (EBGs) and clinical decision support (CDS) is significantly hampered by widespread clinician resistance to it. Our study was designed to better understand the reasons for this resistance to CDS and explore the factors that drive it.

Methods: We used a mixed-methods approach to explore and identify the drivers of resistance for CDS among clinicians, including a web-based multispecialty survey exploring clinicians' impressions of the strengths and weaknesses of CDS, two clinician focus groups, and several one-on-one focused clinician interviews in which individual participants were asked to comment on their rationale for choosing imaging utilization that might not be supported by EBGs.

Purposeful Remote Radiology Education: Strategies and Recommendations.

The COVID-19 global pandemic has presented new challenges to radiology educators and their learners. As a specialty that is accustomed to adapting to continual technologic innovation, as well as one with the capacity for remote work, radiology is uniquely positioned to meet these challenges by taking advantage of online remote educational strategies. This represents an opportunity to not only leverage new methods and technologies but also reexamine the most effective way to implement established ones.

Review of Artificial Intelligence Training Tools and Courses for Radiologists.

Artificial intelligence (AI) systems play an increasingly important role in all parts of the imaging chain, from image creation to image interpretation to report generation. In order to responsibly manage radiology AI systems and make informed purchase decisions about them, radiologists must understand the underlying principles of AI. Our task force was formed by the Radiology Research Alliance (RRA) of the Association of University Radiologists to identify and summarize a curated list of current educational materials available for radiologists.

Incidental CT Findings Suspicious for COVID-19-Associated Pneumonia on Nuclear Medicine Examinations: Recognition and Management Plan.

Some patients undergoing routine SPECT/CT and PET/CT examinations during the COVID-19 pandemic may incidentally reveal findings of COVID-19-associated pneumonia (C-19AP) on localizing CT. It is critical for nuclear medicine physicians to develop diagnostic skills for timely recognition of typical findings of C-19AP on a localizing CT. Furthermore, it is our responsibility to know the optimal practices for safely isolating and managing such patients while protecting the staff, other patients at the facility, family and/or friend accompanying the patients, and the public in general from risky exposure to COVID-19 sources.

Everything Every Radiologist Always Wanted (and Needs) to Know About Clinical Decision Support.

As of January 2020, clinical decision support needs to be implemented across US health systems for advanced diagnostic imaging services. This article reviews the history, importance, and hurdles of clinical decision support and discusses a few pearls and pitfalls regarding its implementation.

Multisite Implementation of Radiology-TEACHES (Technology-Enhanced Appropriateness Criteria Home for Education Simulation).

Purpose: After encouraging results from a single-institution pilot, a novel case-based education portal using integrated clinical decision support at the simulated point of order entry was implemented at multiple institutions to evaluate whether the program is scalable and results transferable. The program was designed to fill key health systems' science gaps in traditional medical education curricula, ultimately aiding the transition from volume to value in health care. The module described uses commonly encountered medical vignettes to provide learners with a low-stakes educational environment to improve their awareness and apply curricular content regarding appropriate resource utilization, patient safety, and cost.

Downregulation of CD73 associates with T cell exhaustion in AML patients.

Background: Successful treatment for acute myeloid leukemia (AML) remains challenging. Inhibiting immune checkpoint to enhance anti-tumor response is an attractive strategy for effective leukemia therapeutics. CD73 is a recently recognized immune checkpoint mediator that is highly expressed on tumor cells and stromal cells in tumor microenvironment.

Making Learning Fun: Gaming in Radiology Education.

With continued technologic advances, it is not surprising that gaming techniques are increasingly being used in radiology residency programs. This comprehensive review on gaming in radiology education offers insight into the importance of gaming, types of games and principles utilized in gaming, as well as applications that are inherent in artificial intelligence and continued medical education. The advantages and disadvantages of gaming will be considered, as well as barriers to successful adoption of gaming.

Applications of Ventilation-Perfusion Scintigraphy in Surgical Management of Chronic Obstructive Lung Disease and Cancer.

Ventilation-perfusion scintigraphy (VPS) depicts the two main physiological processes that are fundamental to oxygen-dependent life. The test has affirmed its critical place in the evaluation of patients with lung cancer preparing for lung resection. The results of the study can differentiate patients who are very likely to survive surgery and the subsequent pulmonary function loss from those who are not.

Evaluation of Three-Dimensional Printed Materials for Simulation by Computed Tomography and Ultrasound Imaging.

Introduction: The use of three-dimensional (3D) printing allows for creation of custom models for clinical care, education, and simulation. Medical imaging, given the significant role it plays in both clinical diagnostics and procedures, remains an important area for such education and simulation. Unfortunately, the materials appropriate for use in simulation involving radiographic or ultrasound imaging remains poorly understood.

Quality metrics currently used in academic radiology departments: results of the QUALMET survey.

Objective: We present the results of the 2015 quality metrics (QUALMET) survey, which was designed to assess the commonalities and variability of selected quality and productivity metrics currently employed by a large sample of academic radiology departments representing all regions in the USA.

Methods: The survey of key radiology metrics was distributed in March-April of 2015 via personal e-mail to 112 academic radiology departments.

Results: There was a 34.

Oral Cholecystagogue Cholescintigraphy: A Systematic Review of Fatty Meal Options.

Objectives: Intermittent unavailability of sincalide for determination of gallbladder ejection fraction (GBEF) prompted increased usage of fatty meal cholecystagogues (FMCs). The aim of this systematic review was to identify the state of current FMC options in cholescintigraphy, focusing on the quality of corresponding normal GBEF values.

Methods: We performed an extensive literature search of the MEDLINE, Cochrane, and CINAHL databases without date or language restrictions with a broad spectrum of search terms.

Bacillus Calmette-Guerin injections for melanoma immunotherapy: potential for a false-positive PET/CT.

An 82-year-old woman presented for routine follow-up PET/CT after undergoing local melanoma resection in the left lower leg, isolated limb infusion chemotherapy, and immunomodulation therapy with Bacillus Calmette-Guérin (BCG) vaccine. Symmetric, bilateral, moderately intense FDG avid axillary and inguinal cutaneous nodules were observed that were new from the prior PET-CT. The patient had developed skin lesions at the BCG injection sites several months before the study.

Standing prone positioning in establishing causality between matched ventilation-perfusion defects and pleural effusion.

Ventilation-perfusion scintigraphy is routinely performed in patients with suspected pulmonary thromboembolism. Pleural effusions in such patients are common and can cause matched ventilation-perfusion defects. This is especially true of the posterior projections in the supine patient.

False-positive PET/CT for lymphoma recurrence secondary to Langerhans cell histiocytosis.

A 28-year-old man with a history of Hodgkin lymphoma that was intensely [F-18]fluoro-2-deoxy-D-glucose-avid at diagnosis had achieved complete remission following appropriate therapy. On surveillance positron emission tomography/computed tomography (CT), new, intensely [F-18]fluoro-2-deoxy-D-glucose-avid lesions (lytic on CT) were seen within the vertebral body of C7, left scapula, and right glenoid. The findings of a biopsy revealed these lesions to be Langerhans cell histiocytosis.

Testicular ascent as a mechanism for intra-abdominal torsion.

Testicular ascent, while uncommon, can occur. A testicle that has ascended out of the scrotum can torse and may present as an acute inguinal mass or acute abdomen. Testicle ascent can occur even if previous intra-scrotal location has been documented.

Automated time-lapse microscopy and high-resolution tracking of cell migration.

We describe a novel fully automated high-throughput time-lapse microscopy system and evaluate its performance for precisely tracking the motility of several glioma and osteoblastic cell lines. Use of this system revealed cell motility behavior not discernable with conventional techniques by collecting data (1) from closely spaced time points (minutes), (2) over long periods (hours to days), (3) from multiple areas of interest, (4) in parallel under several different experimental conditions. Quantitation of true individual and average cell velocity and path length was obtained with high spatial and temporal resolution in "scratch" or "wound healing" assays.

Lysophosphatidic acid induces chemotaxis in MC3T3-E1 osteoblastic cells.

Lysophosphatidic acid (LPA) is a bioactive lipid that has pleiotropic effects on a variety of cell types and enhances the migration of endothelial and cancer cells, but it is not known if this lipid can alter osteoblast motility. We performed transwell migration assays using MC3T3-E1 osteoblastic cells and found LPA to be a potent chemotactic agent. Quantitative time-lapse video analysis of osteoblast migration after wounds were introduced into cell monolayers indicated that LPA stimulated both migration velocity and the average migration distance per cell.

Human and rat glioma growth, invasion, and vascularization in a novel chick embryo brain tumor model.

The mechanisms that control the insidiously invasive nature of malignant gliomas are poorly understood, and their study would be facilitated by an in vivo model that is easy to manipulate and inexpensive. The developing chick embryo brain was assessed as a new xenograft model for the production, growth, and study of human and rat glioma cell lines. Three established glioma lines (U-87 MG, C6, and 9L) were injected into chick embryo brain ventricles on embryonic day (E) 5 and brains were examined after several days to two weeks after injection.