Communication of Incidental Imaging Findings on Inpatient Discharge Summaries After Implementation of Electronic Health Record Notification System.

Objectives: Inadequate follow-up of incidental imaging findings (IIFs) can result in poor patient outcomes, patient dissatisfaction, and provider malpractice. At our institution, radiologists flag IIFs during report dictation to trigger electronic health record (EHR) notifications to providers and patients. Nurse coordinators directly contact patients or their primary care physicians (PCPs) regarding IIFs if follow-up is not completed within the recommended time frame.

Low-Field-Strength Body MRI: Challenges and Opportunities at 0.55 T.

Advances in MRI technology have led to the development of low-field-strength (hereafter, "low-field") (0.55 T) MRI systems with lower weight, fewer shielding requirements, and lower cost than those of traditional (1.5-3 T) systems.

Impact of Predictive Text Clinical Decision Support on Imaging Order Entry in the Emergency Department.

Purpose: Imaging clinical decision support (CDS) is designed to assist providers in selecting appropriate imaging studies and is now federally required. The aim of this study was to understand the effect of CDS on decisions and workflows in the emergency department (ED).

Methods: The authors' institution's order entry platform serves up structured indications for imaging orders.

Quality Control of Magnetic Resonance Elastography Using Percent Measurable Liver Volume Estimation.

Background: Although studies have described factors associated with failed magnetic resonance elastography (MRE), little is known about what factors influence usable elastography data.

Purpose: To identify factors that have a negative impact on percent measurable liver volume (pMLV), defined as the proportion of usable liver elastography data relative to the volume of imaged liver in patients undergoing MRE.

Study Type: Retrospective.

Imaging Biomarkers of Hepatic Fibrosis: Reliability and Accuracy of Hepatic Periportal Space Widening and Other Morphologic Features on MRI.

The purpose of this article was to assess the reliability and accuracy of hepatic periportal space widening and other qualitative imaging features for the prediction of hepatic fibrosis. This single-center retrospective study identified consecutive patients who had undergone liver MR elastography. Two abdominal radiologists independently reviewed anatomic images, assessing multiple qualitative features of chronic liver disease (CLD) including periportal space widening.

Spontaneous rupture of the inferior vena cava (IVC) in the setting of IVC filter thrombosis: case report.

Spontaneous rupture of the inferior vena cava (IVC) is a rare entity. We report a case of a spontaneous IVC rupture associated with IVC filter thrombosis in a patient presenting with severe atraumatic back pain. Computed tomography (CT) identified a retroperitoneal hematoma and suggested IVC thrombosis.

Large-Scale Assessment of Scan-Time Variability and Multiple-Procedure Efficiency for Cross-Sectional Neuroradiological Exams in Clinical Practice.

Scheduling of CT and MR exams requires reasonable estimates for expected scan duration. However, scan-time variability and efficiency gains from combining multiple exams are not quantitatively well characterized. In this work, we developed an informatics approach to quantify typical duration, duration variability, and multiple-procedure efficiency on a large scale, and used the approach to analyze 48,766 CT- and MR-based neuroradiological exams performed over one year.

JOURNAL CLUB: Hepatopancreaticobiliary Imaging Second-Opinion Consultations: Is There Value in the Second Reading?

Objective: Tertiary care practices increasingly provide second-opinion consultations on reports from outside practices or institutions. This practice of providing a second opinion has been studied in a variety of subspecialties; however, its potential effect on the management of hepatopancreaticobiliary (HPB) disease is not known. The purpose of this study was to assess the rate of significant discrepancies between the initial report and the consultation report, the source of discrepancies, and the frequency of repeat imaging recommendations.

Utility of a multidisciplinary tumor board in the management of pancreatic and upper gastrointestinal diseases: an observational study.

Background & Objectives: Multidisciplinary tumor boards (MDTBs) are frequently employed in cancer centers but their value has been debated. We reviewed the decision-making process and resource utilization of our MDTB to assess its utility in the management of pancreatic and upper gastrointestinal tract conditions.

Methods: A prospectively-collected database was reviewed over a 12-month period.

Multimodality Imaging Approach towards Primary Aortic Sarcomas Arising after Endovascular Abdominal Aortic Aneurysm Repair: Case Series Report.

Primary aortic neoplasms are rare. Aortic sarcoma arising after endovascular aneurysm repair (EVAR) is a scarce subset of primary aortic malignancies, reports of which are infrequent in the published literature. The diagnosis of aortic sarcoma is challenging due to its non-specific clinical presentation, and the prognosis is poor due to delayed diagnosis, rapid proliferation, and propensity for metastasis.

Imaging of tailgut cysts.

Tailgut cysts are congenital lesions that arise from the primitive hindgut in the true embryonic tail but fail to regress during gestation. These lesions are rare and more frequently encountered later in life and more commonly in women, and are the most common primary retrorectal tumor. Tailgut cysts may be asymptomatic or cause rectal bleeding, pain, or symptoms related to mass effect on the rectum or bladder.

Cervical gross tumor volume dose predicts local control using magnetic resonance imaging/diffusion-weighted imaging-guided high-dose-rate and positron emission tomography/computed tomography-guided intensity modulated radiation therapy.

Purpose: Magnetic resonance imaging/diffusion weighted-imaging (MRI/DWI)-guided high-dose-rate (HDR) brachytherapy and (18)F-fluorodeoxyglucose (FDG) - positron emission tomography/computed tomography (PET/CT)-guided intensity modulated radiation therapy (IMRT) for the definitive treatment of cervical cancer is a novel treatment technique. The purpose of this study was to report our analysis of dose-volume parameters predicting gross tumor volume (GTV) control.

Methods And Materials: We analyzed the records of 134 patients with International Federation of Gynecology and Obstetrics stages IB1-IVB cervical cancer treated with combined MRI-guided HDR and IMRT from July 2009 to July 2011.

Prostate magnetic resonance imaging: challenges of implementation.

Prostate cancer is among the most common causes of cancer and cancer deaths in men. Screening methods and optimal treatments have become controversial in recent years. Prostate magnetic resonance imaging (MRI) is gaining popularity as a tool to assist diagnosis, risk assessment, and staging.

PACS administrators' and radiologists' perspective on the importance of features for PACS selection.

Picture archiving and communication systems (PACS) play a critical role in radiology. This paper presents the criteria important to PACS administrators for selecting a PACS. A set of criteria are identified and organized into an integrative hierarchical framework.

Whole-body simultaneous positron emission tomography (PET)-MR: optimization and adaptation of MRI sequences.

The purpose of this article is to introduce the underlying challenges associated with the incorporation of magnetic resonance imaging (MRI) into the new hybrid imaging modality simultaneous positron emission tomography (PET)/MR and their impact on attenuation correction, sequence optimization, and protocol development. Many adjustments to MR sequences are necessary for optimal whole-body and fused image results.

Combined hepatocellular-cholangiocarcinoma: what the radiologist needs to know about biphenotypic liver carcinoma.

Combined hepatocellular-cholangiocarcinoma (CHC), also referred to as primary liver carcinoma (PLC) with biphenotypic differentiation, is an increasingly recognized subtype of malignant PLC encompassing varying morphologic forms thought to arise either from progenitor cell lineage or dedifferentiation of mature liver cells. Tumor cells express both biliary and hepatocellular markers by immunohistochemistry, and may also express progenitor cell and stem cell markers. Due to the relative rarity of this tumor type, little is known about the risk factors, imaging appearance, or prognosis.

Magnetic resonance imaging of iatrogeny: understanding imaging artifacts related to medical devices.

Medical devices are frequently encountered in patients presenting for imaging studies. Knowledge of the device composition, dwell time, and location is essential for determining the safety and potential impact on the quality of magnetic resonance imaging (MRI) examinations. Anticipation of MRI artifacts associated with implanted devices allows the radiologist to adjust parameters to mitigate their effect on the anatomy of interest and to avoid pitfalls in interpretation.

Subtypes of renal cell carcinoma: MRI and pathological features.

Renal cell carcinoma (RCC) is the most common malignant tumor involving the kidney. Determining the subtypes of renal cell carcinoma is among the major goals of preoperative radiological work-up. Among all modalities, magnetic resonance imaging (MRI) has several advantages, such as inherent soft tissue contrast, detection of lipid and blood products, and excellent sensitivity to detect small amounts of intravenous contrast, which facilitate the discrimination of subtypes of RCC.

Sensitivity of endoscopic ultrasound, multidetector computed tomography, and magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum: a tertiary center experience.

Objectives: There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: (1) evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP), and multidetector computed tomography (MDCT) for pancreas divisum; and (2) assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP.

Methods: For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography who underwent EUS and cross-sectional imaging.

Tumor volume and subvolume concordance between FDG-PET/CT and diffusion-weighted MRI for squamous cell carcinoma of the cervix.

Purpose: To compare [(18)F]fluorodeoxyglucose (FDG)/positron emission tomography (PET)/computed tomography (CT) and magnetic resonance imaging (MRI) for evaluating patients with cervical cancer. We compared tumor characteristics on FDG-PET and apparent diffusion coefficient (ADC) maps on diffusion-weighted MRI (DWI) to evaluate concordance of two functional imaging techniques.

Materials And Methods: Twenty women with cervical cancer underwent pretreatment FDG-PET/CT and pelvic MRI.

MR imaging findings of ectopic pregnancy: a pictorial review.

Because of its lack of ionizing radiation and excellent soft-tissue contrast, magnetic resonance (MR) imaging is being increasingly used in the evaluation of acute abdominal pain in the pregnant patient. Roughly 2% of all pregnancies are ectopic. Although ectopic pregnancy is usually diagnosed on the basis of a combination of clinical, laboratory, and ultrasonographic findings, it occasionally is initially identified at MR imaging.

ACR Appropriateness Criteria® Suspected upper extremity deep vein thrombosis.

Upper-extremity venous thrombosis often presents as unilateral arm swelling. The differential diagnosis includes lesions compressing the veins and causing a functional venous obstruction, venous stenosis, an infection causing edema, obstruction of previously functioning lymphatics, or the absence of sufficient lymphatic channels to ensure effective drainage. The following recommendations are made with the understanding that venous disease, specifically venous thrombosis, is the primary diagnosis to be excluded or confirmed in a patient presenting with unilateral upper-extremity swelling.