Contemporary Management of Blunt Splenic Trauma in Adults: An Analysis of the Trauma Quality Improvement Program Registry.

Purpose: The aim of this study was to evaluate the effectiveness of management strategies for blunt splenic injuries in adult patients.

Methods: Patients 18 years and older with blunt splenic injuries registered via the Trauma Quality Improvement Program (2013-2019) were identified. Management strategies initiated within 24 hours of hospital presentation were classified as watchful waiting, embolization, surgery, or combination therapy.

Optimizing emergency department imaging utilization for pulmonary emboli: A study on the effects of IV contrast rationing.

Purpose: To study the impact of a contrast mitigation protocol on imaging utilization for pulmonary embolism (PE) in the emergency department (ED).

Material And Methods: Medical records of ED patients with suspected PE who underwent CT pulmonary angiography (CTPA) or ventilation-perfusion (VQ) scans were analyzed in control (3/15/22-4/15/22) and test (5/15/22-6/15/22) periods. The test period included a contrast mitigation protocol due to a global iodinated contrast shortage (05/2022-06/2022).

ACR Appropriateness Criteria® Imaging After Total Knee Arthroplasty: 2023 Update.

Total knee arthroplasty is the most commonly performed joint replacement procedure in the United States. This manuscript will discuss the recommended imaging modalities for six clinical variants; 1. follow-up of symptomatic or asymptomatic patients with a total knee arthroplasty.

The Remote Academic Radiologist: Expert Panel Narrative Review.

The importance of developing a robust remote workforce in academic radiology has come to the forefront owing to several converging factors. COVID-19, as well as the abrupt transformation it precipitated in terms of how radiologists work, has been the biggest impetus for change; concurrent factors such as increasing examination volumes and radiologist burnout have also contributed. How to best advance the most desirable and favorable aspects of remote work while preserving an academic environment that fulfills the tripartite mission is a critical challenge that nearly all academic institutions face today.

Daytime, evening, and overnight: the 24-h radiology cycle and impact on interpretative accuracy.

Purpose: To assess the influence of time of day when a study is interpreted on discrepancy rates for common and advanced studies performed in the acute community setting.

Methods: This retrospective study used the databank of a U.S.

Radiologist age and diagnostic errors.

Purpose: Previous investigations into the causes of error by radiologists have addressed work schedule, volume, shift length, and sub-specialization. Studies regarding possible associations between radiologist errors and radiologist age and timing of residency training are lacking in the literature, to our knowledge. The aim of our study was to determine if radiologist age and residency graduation date is associated with diagnostic errors.

Are Academic Emergency Radiologists Systematically Disadvantaged Compared With Diagnostic Radiology Subspecialty Counterparts When It Comes to Promotion?

Purpose: The aim of this study was to assess academic rank differences between academic emergency and other subspecialty diagnostic radiologists.

Methods: Academic radiology departments likely containing emergency radiology divisions were identified by inclusively merging three lists: Doximity's top 20 radiology programs, the top 20 National Institutes of Health-ranked radiology departments, and all departments offering emergency radiology fellowships. Within departments, emergency radiologists (ERs) were identified via website review.

Time ratio disparities among ED patients undergoing head CT.

Purpose: To assess if patients who underwent head computed tomography (CT) experienced disparities in the emergency department (ED) and if the indication for head CT affected disparities.

Methods: This study employed a retrospective, IRB-approved cohort design encompassing four hospitals. All ED patients between January 2016 and September 2020 who underwent non-contrast head CTs were included.

Lessons Learned in Change Management in Deploying Novel Informatics Solutions: Experience Implementing a Point-of-Care Patient Photography System with Radiography.

We describe implementation of a point-of-care system for simultaneous acquisition of patient photographs along with portable radiographs at a large academic hospital. During the implementation process, we observed several technical challenges in the areas of (1) hardware-automatic triggering for photograph acquisition, camera hardware enclosure, networking, and system server hardware and (2) software-post-processing of photographs. Additionally, we also faced cultural challenges involving workflow issues, communication with technologists and users, and system maintenance.

Contemporary Management of Blunt Liver Trauma: An Analysis of the Trauma Quality Improvement Program Registry (2007-2019).

Purpose: To evaluate the effectiveness of management strategies for blunt liver injuries in adult patients.

Materials And Methods: Patients aged ≥18 years with blunt liver injuries registered via the Trauma Quality Improvement Program (2007-2019) were identified. Management strategies initiated within 24 hours of hospital presentation were classified as nonoperative management (NOM), embolization, surgery, or combination therapy.

Are disparities in emergency department imaging exacerbated during high-volume periods?

Purpose: Evaluate if disparities in the emergency department (ED) imaging timeline exist, and if disparities are altered during high volume periods which may stress resource availability.

Methods: This retrospective study was conducted at a four-hospital healthcare system. All patients with at least one ED visit containing imaging from 1/1/2016 to 9/30/2020 were included.

Artificial Intelligence/Machine Learning Education in Radiology: Multi-institutional Survey of Radiology Residents in the United States.

Rationale And Objectives: To evaluate radiology residents' perspectives regarding inclusion of artificial intelligence/ machine learning (AI/ML) education in the residency curriculum.

Materials And Methods: An online anonymous survey was sent to 759 residents at 21 US radiology residency programs. Resident demographics, sub-specialty interests, educational background and research experiences, as well as the awareness, availability, and usefulness of various resources for AI/ML education were collected.

Imaging of Soft Tissue Infections.

Although superficial infections can often be diagnosed and managed clinically, physical examination may lack sensitivity and specificity, and imaging is often required to evaluate the depth of involvement and identify complications. Depending on the area of involvement, radiography, ultrasound, CT, MR imaging, or a combination of imaging modalities may be required. Soft tissue infections can be nonnecrotizing or necrotizing, with the later having a morbid and rapid course.

Utilization of Chest and Abdominopelvic CT for Traumatic Injury From 2011 to 2018: Evaluation Using a National Commercial Database.

Increases in the use of CT to evaluate patients presenting with trauma have raised concern about inappropriate imaging. The evolving utilization of CT for trauma evaluation may be impacted by injury severity. The purpose of this study was to explore patterns in utilization of chest and abdominopelvic CT among trauma-related emergency department (ED) visits across the United States.

Utilizing a combined hospital and criminal justice database to identify risk factors for repeat firearm injury or violent-crime arrest among firearm victims.

Identifying firearm victims with the greatest risk of repeat-firearm exposure and offering interventions has the potential to disrupt recurrent violence. This study explored risk factors associated with repeat violence among survivors of intentional firearm injury in a unique clinical and criminal justice (CJ) dataset. This study analyzed a retrospective cohort (n = 4058) of persons injured by nonfatal intentional firearm violence from 2013 to 2016 in one metropolitan area.

Comparative effectiveness of pelvic arterial embolization versus laparotomy in adults with pelvic injuries: A National Trauma Data Bank analysis.

Purpose: To compare the clinical outcomes and trends of arterial embolization (AE) versus laparotomy which are used in the management of pelvic trauma.

Materials And Methods: Adult patients with pelvic injuries were identified using the National Trauma Data Bank (NTDB) from 2007 to 2015. Patients with non-pelvic life-threatening injuries were excluded.

ACR Appropriateness Criteria® Nontraumatic Chest Wall Pain.

Chest pain is a common reason that patients may present for evaluation in both ambulatory and emergency department settings, and is often of musculoskeletal origin in the former. Chest wall syndrome collectively describes the various entities that can contribute to chest wall pain of musculoskeletal origin and may affect any chest wall structure. Various imaging modalities may be employed for the diagnosis of nontraumatic chest wall conditions, each with variable utility depending on the clinical scenario.

Interpretations of Examinations Outside of Radiologists' Fellowship Training: Assessment of Discrepancy Rates Among 5.9 Million Examinations From a National Teleradiology Databank.

In community settings, radiologists commonly function as multispecialty radiologists, interpreting examinations outside of their area of fellowship training. The purpose of this article was to compare discrepancy rates for preliminary interpretations of acute community-setting examinations that are concordant versus discordant with interpreting radiologists' area of fellowship training. This retrospective study used the databank of a U.

Increasing Utilization of Emergency Department Neuroimaging From 2007 Through 2017.

The volume of emergency department (ED) visits and the number of neuroimaging examinations have increased since the start of the century. Little is known about this growth in the commercially insured and Medicare Advantage populations. The purpose of our study was to evaluate changing ED utilization of neuroimaging from 2007 through 2017 in both commercially insured and Medicare Advantage enrollees.

Disproportionate Use in Minor Trauma Is Driving Emergency Department Cervical Spine Imaging: An Injury Severity Score-Based Analysis.

Purpose: Clinical practice guidelines intended to reduce unnecessary cervical spine imaging have yielded mixed results. We aimed to assess evolving emergency department (ED) cervical spine imaging utilization in patients with trauma by injury severity.

Methods: Using 2009 to 2018 IBM MarketScan Commercial Databases, we identified ED trauma encounters, associated cervical spine imaging, and related diagnosis codes.

Radiologist errors by modality, anatomic region, and pathology for 1.6 million exams: what we have learned.

Purpose: To evaluate the feasibility of adding pathology to recent radiologist error characterization schemes of modality and anatomic region and the potential of this data to more specifically inform peer review and peer learning.

Methods: Quality assurance data originating from 349 radiologists in a national teleradiology practice were collected for 2019. Interpretive errors were simply categorized as major or minor.

Imaging Manifestations of Chest Trauma.

Trauma is the leading cause of death among individuals under 40 years of age, and pulmonary trauma is common in high-impact injuries. Unlike most other organs, the lung is elastic and distensible, with a physiologic capacity to withstand significant changes in contour and volume. The most common types of lung parenchymal injury are contusions, lacerations, and hematomas, each having characteristic imaging appearances.