MRI of penile fracture: what should be a tailored protocol in emergency?

OBJECTIVES: To conduct a review of literature to summarize the existing MRI protocols for penile trauma, suggesting a tailored protocol to reduce costs and time of examination. MATERIALS AND METHODS: A systematic search was performed in Medline, Embase, Cochrane Library, and Cinahl databases from 1995 to 2015 to identify studies evaluating penis trauma with MRI examination. Studies were included if there was the description of MRI protocol with at least sequences and orthogonal planes used. We chose a systematic approach for data extraction and descriptive synthesis. RESULTS: 12 articles were included in our study. Among the list of 12 articles: 2 were case reports, 3 were clinical series, and 7 were reviews. Clinical trials were not found. There is no unanimous consensus among the authors. Summarizing the data, the most used protocol is characterized by T2 sequences in three orthogonal planes plus T1 sequences in one plane (either axial or sagittal) without contrast medium injection. CONCLUSION: There is a lack of a standard protocol. A tailored protocol to answer the diagnostic question, reducing costs and time of examination, is characterized by T2 sequences in three orthogonal planes plus at least a T1 sequence (either axial or sagittal plane).

The role of imaging specialists as authors of systematic reviews on diagnostic and interventional imaging and its impact on scientific quality: report from the EuroAIM Evidence-based Radiology Working Group.

PURPOSE: To evaluate the inclusion of radiologists or nuclear medicine physicians (imaging specialists) as authors of systematic reviews (SRs) on imaging and imaging-guided diagnostic procedures and to determine the impact of imaging specialists' presence as authors on the overall quality of the reviews. MATERIALS AND METHODS: A MEDLINE and EMBASE search was performed for SRs of diagnostic and interventional image-guided procedures that were published from January 2001 to December 2010. SRs about procedures primarily performed by nonimaging specialists were excluded. The inclusion of imaging specialists among the SR authors and the frequency of publication in imaging journals were evaluated. The quality of a subset of 200 SRs (100 most recent SRs with imaging specialists as authors and 100 most recent SRs without imaging specialists as authors) was rated by using a 12-item modified assessment of multiple SRs (AMSTAR) evaluation tool. Spearman, χ(2), and Mann-Whitney statistics were used. RESULTS: From among 3258 retrieved citations, 867 SRs were included in the study. Neuroimaging had the largest number of SRs (28% [241 of 867]), 41% (354 of 867) of SRs concerned diagnostic performance, and 26% (228 of 867) of SRs were published in imaging journals. Imaging specialists were authors (in any position) in 330 (38%) of 867 SRs; they were first authors of 176 SRs and last authors of 161 SRs. SRs with imaging specialists as authors were more often published in imaging journals than in nonimaging journals (54% [179 of 330] vs 9% [49 of 537]; P < .001). The median number of modified AMSTAR quality indicators was nine in SRs with imaging specialists as authors, while that in SRs without imaging specialists as authors was seven (P = .003). CONCLUSION: Only 38% (330 of 867) of SRs on radiology or nuclear medicine-related imaging published from January 2001 to December 2010 included imaging specialists as authors. However, the inclusion of imaging specialists as authors was associated with a significant increase in the scientific quality (as judged by using a modified AMSTAR scale) of the SR.

The abstract format of original articles: differences between imaging and non-imaging journals.

OBJECTIVES: To compare the abstract structure in the 70 highest-rank imaging journals with that of the two highest-rank journals in each of 35 non-imaging biomedical categories, according to 2008 impact factors. METHODS: We searched on MEDLINE for articles published in high-ranking imaging and non-imaging journals. Abstract format was considered as: IMRaD (Introduction, Methods, Results, and Discussion/conclusion); extended structured (ES), when including headings other than IMRaD; or narrative (without headings). RESULTS: Abstracts of the 70 highest-rank imaging journals were: IMRaD, n = 43 (61%); narrative, n = 27 (39%); ES, n = 0. Abstracts of the 70 highest-rank non-imaging journals were: IMRaD, n = 26 (37%); narrative, n = 35 (50%); ES, n = 9 (13%) (p = 0.001). Additional headings were: study design, n = 7; measurements, n = 7; context/setting, n = 4; interventions, n = 2; rationale, n = 1; level of evidence, n = 1; clinical relevance, n = 1. Study design was declared in 12/23 abstracts (57%) and 21/23 (91%) article bodies in Radiology, 6/21 (29%) and 10/21 (48%) in Investigative Radiology, 11/24 (46%) and 18/24 (75%) in European Radiology, and 12/30 (40%) and 23/30 (77%) in American Journal of Roentgenology, respectively. CONCLUSIONS: Although about 60% of imaging journals adhere to IMRaD format, 13% of non-imaging journals requires additional headings; ES abstracts may assist readers in selecting full articles to be read.

Relevant incidental findings at abdominal multi-detector contrast-enhanced computed tomography: A collateral screening?

AIM: To investigate the prevalence of relevant incidental findings (RIFs) detected during routine abdominal contrast-enhanced computed tomography (CeCT). METHODS: We retrospectively evaluated the reports of a consecutive series of abdominal CeCT studies performed between January and May 2013. For each report, patients' age and sex, admission as inpatient or outpatient, clinical suspicion as indicated by the requesting physician, availability of a previous abdominal examination, and name of the reporting radiologist were recorded. Based on the clinical suspicion, the presence and features of any RIFs (if needing additional workup) was noted. RESULTS: One thousand forty abdominal CeCT were performed in 949 patients (528 males, mean age 66 ± 14 years). No significant difference was found between inpatients and outpatients age and sex distribution (P > 0.472). RIFs were found in 195/1040 (18.8%) CeCT [inpatients = 108/470 (23.0%); outpatients = 87/570 (15.2%); P = 0.002]. RIFs were found in 30/440 (6.8%) CeCT with a previous exam and in 165/600 (27.5%) without a previous exam (P < 0.001). Radiologists' distribution between inpatients or outpatients was significantly different (P < 0.001). RIFs prevalence increased with aging, except for a peak in 40-49 year group. Most involved organs were kidneys, gallbladder, and lungs. CONCLUSION: A RIF is detected in 1/5 patients undergoing abdominal CeCT. Risk of overdiagnosis should be taken into account.