The ACR Learning Network: Facilitating Local Performance Improvement Through Shared Learning.

Purpose: The ACR Learning Network was established to test the viability of the learning network model in radiology. In this report, the authors review the learning network concept, introduce the ACR Learning Network and its components, and report progress to date and plans for the future.

Methods: Patterned after institutional programs developed by the principal investigator, the ACR Learning Network was composed of four distinct improvement collaboratives.

Blueprint for Implementing and Improving Eligible Inferior Vena Cava Filter Retrieval Across Institutions.

Introduction: Placement of removable inferior vena cava filters (rIVCFs) has increased, but this has not been accompanied by timely removal, with retrieval rates as low as 8.5% at some institutions. Failure to remove rIVCFs that were not medically necessary resulted in increased complications.

Improving appropriate imaging for non-specific low back pain.

Non-specific low back pain (LBP) is a common condition in the USA, with approximately 80% of adults who will have LBP at some point during their life and roughly 30% of the adult population suffering from LBP at any given time. Although LBP is the most common cause of disability in the USA, it often has no identifiable anatomic or physiologic cause. Many patients seeking care for non-specific LBP receive X-rays and other imaging studies.

Incidental Breast Cancer on Chest CT: Is the Radiology Report Enough?

Objective: To determine the frequency of incidental breast findings reported on chest CT for which breast imaging follow-up is recommended, the follow-up adherence rate, and the breast malignancy rate. The relationship between strength of recommendation verbiage and follow-up was also explored.

Methods: A retrospective review was conducted of chest CT reports from July 1, 2018, to June 30, 2019, to identify those with recommendation for breast imaging follow-up.

Regulatory Frameworks for Development and Evaluation of Artificial Intelligence-Based Diagnostic Imaging Algorithms: Summary and Recommendations.

Although artificial intelligence (AI)-based algorithms for diagnosis hold promise for improving care, their safety and effectiveness must be ensured to facilitate wide adoption. Several recently proposed regulatory frameworks provide a solid foundation but do not address a number of issues that may prevent algorithms from being fully trusted. In this article, we review the major regulatory frameworks for software as a medical device applications, identify major gaps, and propose additional strategies to improve the development and evaluation of diagnostic AI algorithms.

Closing the Loop-A Pilot in Health System Improvement.

A significant number of patients are reported to not receive timely completion of their recommended follow-up intervention following the interpretation of their imaging studies, contributing to patient deaths resulting from inaccurate or delayed diagnosis. Though automated critical test notification systems and computerized communication mechanisms currently exist, many institutions are discovering that there continue to be gaps in the completion of follow-up recommendations. Herein, we describe how we developed and implemented a closed-loop program dedicated to identifying such gaps and ensuring patients were aware of and received appropriate follow-up.

Reducing radiation exposure with iterative reconstruction: an inter- and intra-scanner analysis.

Our purpose in this study was to compare delivered radiation exposure via computed tomography dose index volume (CTDI) and dose length production (DLP) measurements from computed tomography (CT) examinations performed on scanners with and without image-quality enhancing iterative reconstruction (IR) software. A retrospective analysis was conducted on randomly selected chest, abdomen, and/or pelvis CT examinations from three different scanners from 1 January 2013 to 31 December 2013. CTDI and DLP measurements were obtained from two CT scanners with and one CT scanner without IR software.

Magnetic resonance imaging findings of central nervous system in lysosomal storage diseases: A pictorial review.

Lysosomal storage diseases (LSD) are a complex group of genetic disorders that are a result of inborn errors of metabolism. These errors result in a variety of metabolic dysfunction and build-up certain molecules within the tissues of the central nervous system (CNS). Although, they have discrete enzymatic deficiencies, symptomology and CNS imaging findings can overlap with each other, which can become challenging to radiologists.

Congenital anomalies of lumbosacral spine: A pictorial review.

Congenital malformations of the lumbosacral spine include spinal dysraphism and caudal anomalies. Most often, these malformations are discovered prenatally or in early infancy, but some are not diagnosed until late childhood or adulthood. The purpose of this pictorial review is to illustrate the multi-modality imaging characteristics in these complex anomalies and to provide a systematic radiological approach aiming at improving diagnostic accuracy.

Transcranial Doppler screening in sickle cell disease: The implications of using peak systolic criteria.

Aim: To compare time average maximum mean velocity (TAMV) and peak systolic velocity (PSV) criteria of Trans Cranial Doppler (TCD) in their ability to predict abnormalities on magnetic resonance imaging (MRI)/magnetic resonance angiogram (MRA) in patients with sickle cell disease.

Methods: A retrospective evaluation was performed of the outcomes in all patients with a Transcranial Doppler examination at our institution since the implementation of the hospital picture archiving and communication system (PACS) system in January 2003 through December 2012. All ultrasound imaging exams were performed by the same technologist with a 3 MHz transducer.

Isolated filar cyst on lumbar spine sonography in infants: a case-control study.

Background: Simple cysts found within the filum terminale of infants on lumbar spine sonography are relatively common, but no study has established their clinical significance.

Objective: To obtain information on the sonographic features of isolated filar cysts and determine their clinical significance in comparison with age- and sex-matched controls.

Materials And Methods: We performed a retrospective review of 644 consecutive spine sonograms in patients younger than 8 months.

Transitions in replication timing in a 340 kb region of human chromosomal R-Band 1p36.1.

DNA replication is initiated within a few chromosomal bands as normal human fibroblasts enter the S phase. In the present study, we determined the timing of replication of sequences along a 340 kb region in one of these bands, 1p36.13, an R band on chromosome 1.