Understanding reasons for image rejection by radiologists and radiographers.

Introduction: A core element of a radiographer's role is the decision on whether a radiograph is sufficient for diagnosis, or a repeat examination is needed. Studies illustrate the disagreement on the diagnostic value of radiographs between radiographers and radiologists, which may influence repeat examinations. This study investigates if parameters contributing to image quality are possible determinants to explain the difference between professions.

Benign Osseous Tumors and Tumor-Like Conditions.

We will provide an imaging-focused discussion of 3 benign bone tumors that do not fit in the categories of cartilaginous tumors or osteoid tumors. We have chosen giant cell tumor of bone, unicameral bone cyst, and fibrous dysplasia. All 3 of these entities are common enough that one does not have to be a musculoskeletal radiologist in a cancer hospital to encounter them occasionally, but none of them should be seen frequently.

Osteoid Tumors of Bone.

We present a review of several bone (osteoid)-forming tumors including enostosis, osteoid osteoma, osteoblastoma, and osteosarcoma. These entities were chosen because they are reasonably common-neither seen every day nor rare. When applicable, recent information about the lesions is included.

Chondroid Tumors of Bone.

Recent scholarship on enchondroma, chondrosarcoma, and chondroblastoma is presented. The focus of this article is on the imaging appearance of these tumors and the means by which they can be distinguished from one another by both clinical and imaging criteria.

Gadolinium-based Contrast Agents Improve Detection of Recurrent Soft-Tissue Sarcoma at MRI.

Purpose: To determine the diagnostic efficacy of gadolinium-based contrast agents for the detection of recurrent soft-tissue sarcoma compared with non-contrast-enhanced conventional MRI sequences.

Materials And Methods: A retrospective study of patients with soft-tissue sarcomas who were imaged from January 2009 to December 2014 was performed. MRI studies from 69 patients (mean age, 61 years ± 15 [standard deviation], 45 men) with recurrent soft-tissue sarcoma and 63 age-, sex-, and tumor-matched controls with positive findings (nonrecurrence) were presented to six musculoskeletal radiologists at a tertiary cancer center in three image groupings.

Interpretation time for screening mammography as a function of the number of computer-aided detection marks.

Computer-aided detection (CAD) alerts radiologists to findings potentially associated with breast cancer but is notorious for creating false-positive marks. Although a previous paper found that radiologists took more time to interpret mammograms with more CAD marks, our impression was that this was not true in actual interpretation. We hypothesized that radiologists would selectively disregard these marks when present in larger numbers.

Confidence Calibration: An Introduction With Application to Quality Improvement.

A probabilistic forecast is one that assigns a probability (or likelihood) to the occurrence of an event. Radiologists commonly make probabilistic judgments in their reports, even if these predictions are not explicitly expressed as numbers. There are calls for radiologists to commit to their probabilistic predictions in a standardized fashion; however, without a mechanism for feedback, there is no opportunity for improvement.

Memory bias in observer-performance literature.

The objective of our study was to determine how authors of published observer-performance experiments dealt with memory bias in study design. We searched online and using "observer study" and "observer performance." We included articles from 1970 or later that reported an observer performance experiment using human observers.

Special Section Guest Editorial: Medical Image Perceptions and Observer Performance.

This guest editorial introduces the special section on Medical Image Perceptions and Observer Performance.

Consultation and citation rates for prior imaging studies and documents in radiology.

Frequently, the consensus conclusion after quality assurance conferences in radiology is that whatever mistake was made could have been avoided if more prior images or documents had been consulted. It is generally assumed that anything that was not specifically cited in the report had not been consulted. Is it actually safe to assume that an image or document that is not cited was also not consulted? It is this question that this investigation addresses.

VIDEO: Preoperative CT Angiography for Fibular Free Flap Reconstructions.

Objective: The objective of this video article is to provide an introduction to the use of fibular free flaps. Normal and variant vascular anatomy of the fibular free flap is discussed, as are imaging acquisition and CT angiography interpretation, computer-assisted design and manufacturing, and the limitations of the fibular free flap.

Conclusion: The fibular free flap is commonly used for head and neck reconstructive surgery.

Model observer for assessing digital breast tomosynthesis for multi-lesion detection in the presence of anatomical noise.

Model observers are widely used in task-based assessments of medical image quality. The presence of multiple abnormalities in a single set of images, such as in multifocal multicentric breast cancer (MFMC), has an immense clinical impact on treatment planning and survival outcomes. Detecting multiple breast tumors is challenging as MFMC is relatively uncommon, and human observers do not know the number or locations of tumors a priori.

F-FDG PET/CT as an Indicator of Survival in Ewing Sarcoma of Bone.

: The existing literature of 18 F-FDG PET/CT in Ewing sarcoma investigates mixed populations of patients with both soft tissue and bone primary tumors. The aim of our study was to evaluate whether the maximum standardized uptake value (SUVmax) obtained with 18F-FDG PET/CT before and after induction chemotherapy can be used as an indicator of survival in patients with Ewing sarcoma originating exclusively in the skeleton. A retrospective database search from 2004-2011 identified 28 patients who underwent 18 F-FDG PET/CT before (SUV1, n= 28) and after (SUV2, n=23) induction chemotherapy.

VIDEO: Preoperative CT Angiography for Anterolateral Thigh Flap Reconstructions.

Objective: This video article will review the relevant vascular anatomy of the anterolateral thigh flap, describe the CT angiography (CTA) image acquisition, and describe how to report the locations of the perforating arteries along with characteristics that may be important to the surgeon.

Conclusion: Our method of performing and reporting CTA for patients scheduled to undergo anterolateral thigh flap reconstruction provides a reproducible method of identifying perforating vessels and communicating their location to surgeons.

Multimodality Imaging Including PET/CT in a Patient with Amyloid Arthropathy and Multiple Myeloma.

We report a case of amyloid arthropathy in a patient with multiple myeloma. Amyloid arthropathy is a very rare condition that may be associated with multiple myeloma. It presented in our patient as soft tissue masses around joints and eroding into adjacent bones.

A half-second glimpse often lets radiologists identify breast cancer cases even when viewing the mammogram of the opposite breast.

Humans are very adept at extracting the "gist" of a scene in a fraction of a second. We have found that radiologists can discriminate normal from abnormal mammograms at above-chance levels after a half-second viewing (d' ∼ 1) but are at chance in localizing the abnormality. This pattern of results suggests that they are detecting a global signal of abnormality.

Radiologists remember mountains better than radiographs, or do they?

Expertise with encoding material has been shown to aid long-term memory for that material. It is not clear how relevant this expertise is for image memorability (e.g.

Computational assessment of visual search strategies in volumetric medical images.

When searching through volumetric images [e.g., computed tomography (CT)], radiologists appear to use two different search strategies: "drilling" (restrict eye movements to a small region of the image while quickly scrolling through slices), or "scanning" (search over large areas at a given depth before moving on to the next slice).

Skeletal Muscle Metastasis from Renal Cell Carcinoma: 21 cases and review of the literature.

Objectives: This study aimed to raise radiologists' awareness of skeletal muscle metastases (SMM) in renal cell carcinoma (RCC) cases and to clarify their imaging appearance.

Methods: A retrospective analysis was undertaken of 21 patients between 44-75 years old with 72 SMM treated from January 1990 to May 2009 at the MD Anderson Cancer Center in Houston, Texas, USA. Additionally, 37 patients with 44 SMM from a literature review were analysed.

Radiologist experience effects on contrast detection.

Current literature shows that radiologist experience does not affect detection tasks when the object does not require medical training to detect. However, the research was never sufficiently detailed to examine if the contrast detection threshold is also the same for radiologists versus nonradiologists. Previously, contrast threshold research was performed predominantly on nonradiologists.

Differentiation of Benign Fluid Collections from Soft-Tissue Sarcomas on FDG-PET/CT.

Objective: To assess the diagnostic performance of (18)F-FDG PET-CT in differentiating soft tissue sarcomas (STSs) from benign fluid collections (BFs).

Materials And Methods: Four readers independently reviewed 100 lesions on (18)F-FDG PET-CT and subjectively classified each lesion as an STS or BF and scored the spatial pattern of (18)F-FDG avidity (SP) of each on a 4-point ordered scale (thin, moderate, thick, solid).

Results: Subjective assessment by readers allowed sensitive (91%-98%) differentiation of STSs from BFs, with lower specificity (59%-91%).

Primary sacrococcygeal chordoma with unusual skeletal muscle metastasis.

Chordomas are rare neoplasms that do not often metastasize. Of the small percent that do metastasize, they very infrequently involve skeletal muscle. Only a few cases of skeletal muscle metastases have been reported in the literature.

Memory for previously viewed radiographs and the effect of prior knowledge of memory task.

Rationale And Objectives: To investigate the effect of being forewarned that they would be asked to identify repeated images on radiologists' recognition of previously interpreted versus new chest radiographs.

Materials And Methods: Thirteen radiologists viewed 60 posterior-anterior chest radiographs, 31 with and 29 without nodules, in two sets of 40 images each. Eight radiologists were forewarned and five radiologists were not forewarned of the memory task.

Stereoscopic interpretation of low-dose breast tomosynthesis projection images.

The purpose of this study was to evaluate stereoscopic perception of low-dose breast tomosynthesis projection images. In this Institutional Review Board exempt study, craniocaudal breast tomosynthesis cases (N = 47), consisting of 23 biopsy-proven malignant mass cases and 24 normal cases, were retrospectively reviewed. A stereoscopic pair comprised of two projection images that were ±4° apart from the zero angle projection was displayed on a Planar PL2010M stereoscopic display (Planar Systems, Inc.