Obstructive Nephropathy from Misplaced Suprapubic Catheter with Antegrade Migration into the Urethra.

Case Presentation: An 83-year-old male with a history of prostate cancer and prior prostatectomy presented with lower abdominal pain, urethral leakage, and hematuria after a routine suprapubic catheter exchange, which was found to be incorrectly positioned in the bulbar urethra, leading to obstructive nephropathy with mild hydronephrosis.

Discussion: This case highlights the increased risk of suprapubic catheter misplacement and complications in elderly patients with neurogenic bladder and altered urinary anatomy, particularly after prostatectomy and artificial urethral sphincter placement. It emphasizes the importance of careful management during catheter exchanges in such patients to prevent complications of misplacement.

Peripheral liver metastases are more frequently missed than central metastases in contrast-enhanced CT: insights from a 25-reader performance study.

Purpose: Subtle liver metastases may be missed in contrast enhanced CT imaging. We determined the impact of lesion location and conspicuity on metastasis detection using data from a prior reader study.

Methods: In the prior reader study, 25 radiologists examined 40 CT exams each and circumscribed all suspected hepatic metastases.

Patient Access of Their Radiology Reports Before and After Implementation of 21st Century Cures Act Information-Blocking Provisions at a Large Multicampus Health System.

To implement provisions of the 21st Century Cures Act that address information blocking, federal regulations mandated that health systems provide patients with immediate access to elements of their electronic health information, including imaging results. The purpose of this study was to compare patient access of radiology reports before and after implementation of the information-blocking provisions of the 21st Century Cures Act. This retrospective study included patients who underwent outpatient imaging examinations from January 1, 2021, through December 31, 2022, at three campuses within a large health system.

Sharing Patient Praises With Radiology Staff: Workflow Automation and Impact on Staff.

Objective: This study aims to develop and evaluate a semi-automated workflow using natural language processing (NLP) for sharing positive patient feedback with radiology staff, assessing its efficiency and impact on radiology staff morale.

Methods: The HIPAA-compliant, institutional review board-waived implementation study was conducted from April 2022 to June 2023 and introduced a Patient Praises program to distribute positive patient feedback to radiology staff collected from patient surveys. The study transitioned from an initial manual workflow to a hybrid process using an NLP model trained on 1,034 annotated comments and validated on 260 holdout reports.

Differences Between Highly Rated vs Poorly Rated Patient Ratings of Radiology Reports.

Objective: To evaluate differences in quantitative features between poorly versus highly rated patient ratings of radiology reports.

Methods: A HIPAA-compliant, IRB-waived study was performed from October 2019 to June 2021. Patients completed an optional 2-question survey ("How helpful was the report?" with a 5-star scale and an open text box) embedded into the patient portal, and reports were assessed for readability and brevity.

Management of Patients With a Negative Multiparametric Prostate MRI Examination: Expert Panel Narrative Review.

Multiparametric MRI (mpMRI) of the prostate aids risk stratification of patients with elevated PSA levels. Although most clinically significant prostate cancers are detected by mpMRI, insignificant cancers are less evident. Thus, multiple international prostate cancer guidelines now endorse routine use of prostate MRI as a secondary screening test before prostate biopsy.

Initial Experience with a COVID-19 Screening Chatbot Before Radiology Appointments.

Guidelines for COVID-19 issued by the Centers for Disease Control and Prevention prompted state and local governments to mandate safety measures for screening high-risk patient populations and for institutions to look for ways to limit human contact when possible. The aim of this study was to determine the feasibility of an automated communication system (chatbot) for COVID-19 screening before patients' radiology appointments and to describe patient experiences with the chatbot. We developed a chatbot for COVID-19 screening before outpatient radiology examination appointments and tested it in a pilot study from July 6 to August 31, 2020.

Using Evidence-Based Criteria to Decrease CT Utilization for Liver Imaging.

Purpose: Overutilization of imaging in radiology increases costs without improvement in patient outcomes. As a part of the regular quality measures, the Centers for Medicare and Medicaid Services deemed our institution to be overutilizing abdomen and abdominopelvic computer tomography (CT) with and without intravenous (IV) contrast. We implemented a quality improvement (QI) effort to reduce use of abdomen CT with and without IV contrast.

Lessons learned from radiology mentors.

As in any field, radiologists may face a number of challenges as they navigate their early careers. Because with experience comes wisdom, early-career radiologists may find helpful the advice and perspectives of mid- and late-career radiologists. The Society of Abdominal Radiology recognizes the value of this pool of knowledge and experience, prompting the establishment of the Early Career Committee.

Patient and Provider Feedback for Radiology Reports: Implementation of a Quality Improvement Project in a Multi-Institutional Setting.

Background: Radiology does not routinely solicit feedback on radiology reports. The aim of the study is to report the feasibility and initial results of a multi-institutional quality improvement project implementing patient and provider feedback for radiology reports.

Methods: A HIPAA-compliant, institutional review board-waived quality improvement effort at two institutions obtaining patient and provider feedback for radiology reports was implemented from January 2018 to May 2020.

Perspective: in pursuit of a learning culture.

Transitioning from peer review to peer learning is an important step forward in developing a learning culture. Additional measures are going to be required to meet this goal. Ideas toward establishing a learning culture are detailed in this perspective.

Implementation of peer learning conferences throughout a multi-site abdominal radiology practice.

Purpose: To initiate a peer learning conference for our abdominal radiology division across multiple geographically separated sites and different time zones, and to determine radiologist preference for peer learning versus traditional score-based peer review.

Methods: We implemented a monthly peer learning videoconference for our abdominal radiology division. Surveys regarding radiologist opinion regarding traditional peer review and the new peer learning conferences were conducted before and after 6 months of conferences.

Availability of a final abdominopelvic CT report before emergency department disposition: risk-adjusted outcomes in patients with abdominal pain.

Objective: To determine whether availability of a final radiologist report versus an experienced senior resident preliminary report prior to disposition affects major care outcomes in emergency department (ED) patient presenting with abdominal pain undergoing abdominopelvic CT.

Materials And Methods: This single-institution, IRB-approved, HIPAA-compliant retrospective cohort study included 5019 ED patients with abdominal pain undergoing abdominopelvic CT from October 2015 to April 2019. Patients were categorized as being dispositioned after either an experienced senior resident preliminary report (i.

Collective Intelligence of Peer Learning: Promoting Culture of Learning and Improvement Among Radiologists.

The traditional Scoring-Based Peer Review system has been the predominant radiology performance quality assurance model, which can become a condemning, ineffective process. In 2015, the Institute of Medicine called for "policies and practices that promote a non-punitive culture that values open discussion and feedback on diagnostic performance." The development of Peer Learning (PL), a process that encompasses peer feedback, learning, and improvement, has positively impacted radiology through the recognition of success, identification of mistakes as learning opportunities, and development of a professional culture of trust.

Upcoming American College of Radiology prostate MRI designation launching: what to expect.

The use of prostate MRI for prostate cancer evaluation continues to rise and ensuring minimum quality standards across practices will enable optimal diagnostic accuracy and thus, patient care. The American College of Radiology has been working on quality standards to meet Prostate MRI Designated Center, which is expected to launch in late 2020. We discuss the background of the American College of Radiology Prostate MRI working group's effort and summarize the criteria for Prostate MRI Designation.

Emergency department length of stay following discontinuation of routine oral contrast material.

Purpose: To determine the effect of discontinuing routine oral contrast material on emergency department (ED) length of stay (LOS), time from order to CT completion, and preliminary report turnaround time (TAT).

Methods: A HIPAA-compliant, IRB-waived, single-institution, retrospective cohort study was conducted on adult patients presenting with abdominal pain to the ED from October 2015 to April 2019. Routine oral contrast material was administered prior to July 2018 and discontinued thereafter.

Transitioning From Peer Review to Peer Learning: Report of the 2020 Peer Learning Summit.

Since its introduction nearly 20 years ago, score-based peer review has not been shown to have meaningful impact on or be a valid measurement instrument of radiologist performance. A new paradigm has emerged, peer learning, which is a group activity in which expert professionals review one another's work, actively give and receive feedback in a constructive manner, teach and learn from one another, and mutually commit to improving performance as individuals, as a group, and as a system. Many radiology practices are beginning to transition from score-based peer review to peer learning.