Non-Conscious Detection of "Missed" Lung Nodules by Radiologists: Expanding the Boundaries of Successful Processing During the Visual Assessment of Chest CT Scans.

Background Diagnostic error rates for detecting small lung nodules on chest CT scans remain high at 50%, despite advances in imaging technology and radiologist training. These failure rates may stem from limitations in conscious recognition processes. However, successful visual processes may be detecting the nodule independent of the radiologist's report.

Multiple expressions of "expert" abnormality gist in novices following perceptual learning.

With a brief half-second presentation, a medical expert can determine at above chance levels whether a medical scan she sees is abnormal based on a first impression arising from an initial global image process, termed "gist." The nature of gist processing is debated but this debate stems from results in medical experts who have years of perceptual experience. The aim of the present study was to determine if gist processing for medical images occurs in naïve (non-medically trained) participants who received a brief perceptual training and to tease apart the nature of that gist signal.

Integrating art museum visits into the radiology curriculum: A program to encourage engagement, observation and analytic skills among millennial learners.

Millennial learners have unique educational preferences and expectations, many of which vary significantly from those of their predecessors. To aid in the preparation and training of the next generation of radiologists, we have been exploring a teaching technique using an art observation training workshop to foster engagement of millennial radiology residents to pay closer attention to image detail, clearly state the observations and synthesize the "story" of the patient's condition. Fine tuning these visual skills is crucial as research shows that over 70% of errors in interpreting diagnostic imaging studies are related to visual perception errors.

Coordination and optimization of FDG PET/CT and COVID-19 vaccination; Lessons learned in the early stages of mass vaccination.

As the world embarks on mass vaccination for COVID-19, we are beginning to encounter unintended dilemmas in imaging oncology patients; particularly with regards to FDG PET/CT. In some cases, vaccine-related lymphadenopathy and FDG uptake on PET/CT can mimic cancer and lead to confounding imaging results. These cases where findings overlap with cancer pose a significant dilemma for diagnostic purposes, follow-up, and management leading to possible treatment delays, unnecessary repeat imaging and sampling, and patient anxiety.

COVID-19 Vaccination-Related Uptake on FDG PET/CT: An Emerging Dilemma and Suggestions for Management.

As mass COVID-19 vaccination is underway, radiologists are encountering transient FDG uptake in normal or enlarged axillary, supraclavicular, and cervical lymph nodes after ipsilateral deltoid vaccination. This phenomenon may confound interpretation in patients with cancer undergoing FDG PET/CT. In this article, we present our institutional approach for management of COVID-19 vaccine-related lymphadenopathy on FDG PET/CT according to early experience.

Enabling Your Radiology Business to Thrive Strategic Lessons Learned During the Initial and Subsequent Surges of the Covid-19 Pandemic.

The Covid-19 pandemic surges of 2020 resulted in major operational, personal, and financial impacts on US radiology practices. In response, a series of strategic and intentional operational changes were implemented, varying by practice size, structure and model. In reviewing the many business lessons that we learned during the pandemic, it became clear that for a business to be successful, a host of additional supportive factors are necessary.

Impact of the COVID-19 pandemic on emergency department CT for suspected diverticulitis.

Purpose: This study examined the impact of the COVID-19 pandemic on emergency department CT use for acute nontraumatic abdominal pain, to better understand why imaging volume so drastically decreased during the COVID-19 pandemic.

Methods: This was a retrospective review of emergency imaging volumes from January 5 to May 30, 2020. Weekly volume data were collected for total imaging studies, abdominopelvic CT, and abdominopelvic CTs positive for common causes of acute nontraumatic abdominal pain.

Impact of Coronavirus Disease 2019 (COVID-19) on the Practice of Clinical Radiology.

The speed at which coronavirus disease 2019 (COVID-19) spread quickly fractured the radiology practice model in ways that were never considered. In March 2020, most practices saw an unprecedented drop in their volume of greater than 50%. The profound changes that have interrupted the arc of the radiology narrative may substantially dictate how health care and radiology services are delivered in the future.

How Radiologists Are Paid: An Economic History, Part II: Advanced Imaging and Radiologists' Incomes.

The advent of the CT scanner in the early 1970s removed much, if not all, of the morbidity and discomfort previously associated with diagnostic imaging studies. Throughout the 1970s and 1980s, advances in CT technology allowed radiologists to scan "better and faster." The professional fee for reading a CT study was higher than for reading a radiograph, an uncontroversial policy.

How Radiologists Are Paid: An Economic History, Part IV: End of the Bubble.

During the first decade of the 21st century, the imaging bubble began to burst. The combination of digitized images, the DICOM standard, and affordable PACS sharply increased radiologists' productivity but also allowed an imaging study to be read from anywhere, creating the field of teleradiology and increased competition for radiologists. Increasing numbers of insurers contracted with radiology benefits managers to help control radiology utilization, and the Deficit Reduction Act of 2005 mandated spending cuts across the government.

How Radiologists Are Paid: An Economic History, Part III: The Bubble Years.

With the collapse of the Clinton health care reforms, advanced imaging entered an economic bubble. Between 1995 and 2006, the number of CT and MRI studies almost tripled, from 21 million to 62 million and from 9.1 to 26.

How Radiologists Are Paid: An Economic History, Part I: The Fight for Independent Billing.

In the first article in a four-part work, the authors review the economic history of how radiologists are paid, from the fight for independent billing in the 1960s to the impact of advanced imaging technologies on radiologists' incomes in the 1980s to the "bubble years" of the 1990s and to the end of the bubble in the first decade of the 21 century. The authors begin in this first part with the connections among a radiologist from Arkansas, a congressman, and the passage of Medicare, the program that gave radiologists the right to bill independently and gave the federal government a big role in health care spending.

Global Radiology Training Prevalence Among Radiology Residency Programs.

Objective: Global Radiology aims to enhance access to medical imaging services and education, worldwide. To date, few reports have evaluated Global Radiology Training (GRT) in radiology residency programs. Here, we examined how radiology residency programs perceive and incorporate GRT into their curriculum, and how this information is promoted online.

Still Coming Out of the Dark: Enduring Effects of Simulation-Based Communication Skills Training for Radiology Residents-Four-Year Follow-Up.

Purpose: To evaluate the long-term efficacy of simulation-based communication skills training for radiology residents.

Method And Materials: The simulation-based communication skills training curriculum was developed in 2014. The curriculum included a teaching module based on the essential elements of communication.

Improving Communication of Actionable Findings in Radiology Imaging Studies and Procedures Using an EMR-Independent System.

The primary purpose of this study is to determine if the implementation of an actionable findings communication system (PeerVue) with explicitly defined criteria for the classification of critical results, leads to an increase in the number of actionable findings reported by radiologists. Secondary goals are to 1) analyze the adoption rate of PeerVue and 2) assess the accuracy of the classification of actionable findings within this system. Over a two-year period, 890,204 radiology reports were analyzed retrospectively in order to identify the number of actionable findings communicated before (Year 1) and after the implementation of PeerVue (Year 2) at a tertiary care academic medical center.

Validation of Adult Relative Radiation Levels Using the ACR Dose Index Registry: Report of the ACR Appropriateness Criteria Radiation Exposure Subcommittee.

The ACR Dose Index Registry (DIR) provides a new source of clinical radiation exposure data that has not been used previously to establish or update the relative radiation level (RRL) values in the ACR Appropriateness Criteria (AC). The results of a recent review of DIR data for 10 common CT examinations were compared with current ACR AC RRL values for the same procedures. The AC RRL values were previously determined by consensus of members of the AC Radiation Exposure Subcommittee based on reference radiation dose values from the literature (when available) and anecdotal information from individual members' clinical practices and experiences.

Screening a small molecule library to identify inhibitors of NF-κB inducing kinase and pro-labor genes in human placenta.

The non-canonical NF-κB signaling (RelB/p52) pathway drives pro-labor genes in the human placenta, including corticotropin-releasing hormone (CRH) and cyclooxygenase-2 (COX-2), making this a potential therapeutic target to delay onset of labor. Here we sought to identify small molecule compounds from a pre-existing chemical library of orally active drugs that can inhibit this NF-κB signaling, and in turn, human placental CRH and COX-2 production. We used a cell-based assay coupled with a dual-luciferase reporter system to perform an in vitro screening of a small molecule library of 1,120 compounds for inhibition of the non-canonical NF-κB pathway.

Population representation among anatomical donors and the implication for medical student education.

Dissection provides a unique opportunity to integrate anatomical and clinical education. Commonly, cadavers are randomly assigned to courses, which may result in skewed representation of patient populations. The primary aim of this study was to determine if the anatomical donors studied by students at the University of Massachusetts Medical School (UMMS) accurately represent the disease burden of the local patient population.

The Relevance of Readmissions after Common IR Procedures: Readmission Rates and Association with Early Mortality.

Purpose: To determine all-cause readmission rates for 12 IR procedures and association of time to readmission with risk-adjusted 90-day mortality.

Materials And Methods: Patients discharged after 12 inpatient IR procedures at a tertiary-care hospital between June 2008 and May 2013 (N = 4,163) were categorized as no readmission (n = 1,479; 40.5%) or readmission between 0 and 7 (n = 379; 10.