Integrative diagnostics: the time is now-a report from the International Society for Strategic Studies in Radiology.

Enormous recent progress in diagnostic testing can enable more accurate diagnosis and improved clinical outcomes. Yet these tests are increasingly challenging and frustrating; the volume and diversity of results may overwhelm the diagnostic acumen of even the most dedicated and experienced clinician. Because they are gathered and processed within the "silo" of each diagnostic discipline, diagnostic data are fragmented, and the electronic health record does little to synthesize new and existing data into usable information.

Integrative Diagnostics: The Time Is Now-A Report From the International Society for Strategic Studies in Radiology.

Enormous recent progress in diagnostic testing can enable more accurate diagnosis and improved clinical outcomes. Yet these tests are increasingly challenging and frustrating; the volume and diversity of results may overwhelm the diagnostic acumen of even the most dedicated and experienced clinician. Because they are gathered and processed within the "silo" of each diagnostic discipline, diagnostic data are fragmented, and the electronic health record does little to synthesize new and existing data into usable information.

Revisiting Current Golden Rules in Managing Acute Ischemic Stroke: Evaluation of New Strategies to Further Improve Treatment Selection and Outcome.

Objective: Advanced stroke imaging has generated much excitement for the early diagnosis of acute ischemic stroke (AIS) and facilitation of intervention. However, its therapeutic impact has not matched its diagnostic utility; most notably, lacking significant contributions to recent major AIS clinical trials. It is time to reexamine the fundamental hypotheses from the enormous body of imaging research on which clinical practices are based and reassess the current standard clinical and imaging strategies, or golden rules, established over decades for AIS.

Towards use of MRI-guided ultrasound for treating cerebral vasospasm.

Cerebral vasospasm is a major cause of morbidity and mortality in patients with subarachnoid hemorrhage (SAH), causing delayed neurological deficits in as many as one third of cases. Existing therapy targets induction of cerebral vasodilation through use of various drugs and mechanical means, with a range of observed efficacy. Here, we perform a literature review supporting our hypothesis that transcranially delivered ultrasound may have the ability to induce therapeutic cerebral vasodilation and, thus, may one day be used therapeutically in the context of SAH.

Brain imaging findings in elderly adults and years of life, healthy life, and able life over the ensuing 16 years: the Cardiovascular Health Study.

Objectives: To determine whether elderly people with different patterns of magnetic resonance imaging (MRI) findings have different long-term outcomes.

Design: Longitudinal cohort study.

Setting: Cardiovascular Health Study.

Validation of optimal DCE-MRI perfusion threshold to classify at-risk tumor imaging voxels in heterogeneous cervical cancer for outcome prediction.

Purpose: To classify tumor imaging voxels at-risk for treatment failure within the heterogeneous cervical cancer using DCE MRI and determine optimal voxel's DCE threshold values at different treatment time points for early prediction of treatment failure.

Material And Method: DCE-MRI from 102 patients with stage IB2-IVB cervical cancer was obtained at 3 different treatment time points: before (MRI 1) and during treatment (MRI 2 at 2-2.5 weeks and MRI 3 at 4-5 weeks).

A guide to the external review of an academic radiology department.

External reviews are used to evaluate a department on a routine basis or prior to reappointment or recruitment of a department chair. The Society of Chairs of Academic Radiology Departments (SCARD) developed a template that outlines important components of an external review report and a table that outlines the objective information that can be requested from the institution/department prior to the reviewer's site visit. The template is meant to facilitate a high-quality review and serve as a guide to a chair who is preparing for his/her first review, chairs who serve as external consultants, and institutional officials seeking review of a radiology department.

Progression of magnetic resonance imaging-defined brain vascular disease predicts vascular events in elderly: the Cardiovascular Health Study.

Background And Purpose: To determine whether progression of MRI-defined vascular disease predicts subsequent vascular events in the elderly.

Methods: The Cardiovascular Health Study, a longitudinal cohort study of vascular disease in the elderly, allows us to address this question because its participants had 2 MRI scans≈5 years apart and have been followed for ≈9 years since the follow-up scan for incident vascular events.

Results: Both MRI-defined incident infarcts and worsened white matter grade were significantly associated with heart failure, stroke, and death, but not transient ischemic attacks, angina, or myocardial infarction.

Scenario planning.

In facing future developments in health care, scenario planning offers a complementary approach to traditional strategic planning. Whereas traditional strategic planning typically consists of predicting the future at a single point on a chosen time horizon and mapping the preferred plans to address such a future, scenario planning creates stories about multiple likely potential futures on a given time horizon and maps the preferred plans to address the multiple described potential futures. Each scenario is purposefully different and specifically not a consensus worst-case, average, or best-case forecast; nor is scenario planning a process in probabilistic prediction.