Adding value to imaging services: a survey of patient and referring physician preferences for direct radiologic reporting of results.

PURPOSE: To identify preferences of patients and referring physicians for direct patient communication and notification of radiologic study results. METHODS: An anonymous survey was conducted of patients undergoing outpatient radiologic imaging studies and their referring physicians. The voluntary surveys elicited responses regarding preferences on a 5-point Likert scale (Strongly disagree, disagree, neutral, agree and strongly agree), as well as indicated by responding yes or no to specific questions. RESULTS: 368 patients completed the survey. 81.5% of patient responders preferred all results communicated from the radiologist within the same day. 65.9% of patients preferred same day results if normal vs 65.8% if abnormal. 34.5% preferred to wait and review normal results with the referring physician. 41.5% preferred to wait and review abnormal results with the referring physician. It was found that patients were more likely to strongly agree with waiting to review results with the referring physician if the results were abnormal, as opposed to normal (18.5% vs 11.9%, respectively; P < 0.014). 64% of physicians did not want results reviewed with their patients; 87.6% did not want a report sent to the patient by the radiologist, even after report was sent to their office. 66.4% of patients surveyed indicated that waiting for imaging results gives them anxiety. CONCLUSIONS: 58-82% of patients preferred same day radiologist communication of their results while 55-87.6% of physicians did not prefer same day radiologist communication of results directly with their patients. 66.4% of patients surveyed indicated that waiting for imaging results gives them anxiety.

Biofilms-Impacts on Human Health and Its Relevance to Space Travel.

As the world looks towards the stars, the impacts of endogenous and exogenous microorganisms on human health during long-duration space flight are subjects of increased interest within the space community. The presence and continued growth of bacterial biofilms about spacecraft has been documented for decades; however, the impact on crew health is in its infancy. The impacts of biofilms are well known in the medical, agricultural, commercial, and industrial spaces. It less known that biofilms are undermining many facets of space travel and that their effects need to be understood and addressed for future space missions. Biofilms can damage space crew health and spoil limited food supply. Yet, at the same time, they can benefit plant systems for food growth, nutrient development, and other biological systems that are being explored for use in space travel. Various biofilm removal techniques have been studied to mitigate the hazards posed by biofilm persistence during space travel. Because the presence of biofilms can advance or hinder humanity's space exploration efforts, an understanding of their impacts over the duration of space flights is of paramount importance.

Machine Learning in Radiology: Applications Beyond Image Interpretation.

Much attention has been given to machine learning and its perceived impact in radiology, particularly in light of recent success with image classification in international competitions. However, machine learning is likely to impact radiology outside of image interpretation long before a fully functional "machine radiologist" is implemented in practice. Here, we describe an overview of machine learning, its application to radiology and other domains, and many cases of use that do not involve image interpretation. We hope that better understanding of these potential applications will help radiology practices prepare for the future and realize performance improvement and efficiency gains.

Radiology's Emerging Role in 3-D Printing Applications in Health Care.

From its inception as a tool for prototype development in the early 1980s, three-dimensional (3-D) printing has made inroads into almost every sector of industry, including health care. Medical applications range from extra- and intracorporeal orthopedic devices to complex, temporal reconstructions of patient-specific anatomy that allow operative planning and education. In the contemporary climate of personalized medicine, the utility of tangible 3-D models extrapolated directly from patient imaging data seems boundless. The purpose of this review is to briefly outline the development of 3-D printing, discuss its applications across the many medical and surgical specialties, and attempt to address obstacles and opportunities facing radiology as this technology continues to be integrated into patient care.

Meaningful Peer Review in Radiology: A Review of Current Practices and Potential Future Directions.

The current practice of peer review within radiology is well developed and widely implemented compared with other medical specialties. However, there are many factors that limit current peer review practices from reducing diagnostic errors and improving patient care. The development of "meaningful peer review" requires a transition away from compliance toward quality improvement, whereby the information and insights gained facilitate education and drive systematic improvements that reduce the frequency and impact of diagnostic error. The next generation of peer review requires significant improvements in IT functionality and integration, enabling features such as anonymization, adjudication by multiple specialists, categorization and analysis of errors, tracking, feedback, and easy export into teaching files and other media that require strong partnerships with vendors. In this article, the authors assess various peer review practices, with focused discussion on current limitations and future needs for meaningful peer review in radiology.

Traumatic Shoulder Dislocation Among Adolescents: Hill-Sachs Lesion Volume and Recurrent Instability.

BACKGROUND: Accurate assessment of Hill-Sachs lesions (HSLs) and their relationship to the glenoid track is essential to optimizing management following traumatic shoulder dislocation. The purpose of this study was to measure the size of HSLs by a novel method with magnetic resonance (MR) arthrography and to investigate the relationship between lesion size and instability history in adolescents (below 19 y of age) with a history of traumatic dislocation. METHODS: All shoulder MR arthrograms queried to identify HSLs over a 4-year period were retrospectively reviewed and independently evaluated by 2 blinded musculoskeletal radiologists. HSLs were evaluated on axial T1-weighted fat-saturated images. For each consecutive image slice in which the HSL was identified, a freehand region of interest was constructed along the compression fracture cavity. Region of interest sum was multiplied by image slice thickness (and gap between slices if present) to generate a total HSL volume (mm). Subject chart review was then performed to acquire demographic data, including shoulder dislocation history. RESULTS: A total of 30 patients met inclusion criteria and included 22 boys (mean age, 16.3 y) and 8 girls (mean age, 16.4 y). Four patients had a history of 1 traumatic dislocation, 12 had a history of 2, and 14 had a history of ≥3. The average size of the HSL for all patients was 3.8 mm (range, 0.52 to 11 mm). There was no significant difference in HSL volume between the 21 skeletally immature (3.7 mm) and 9 skeletally mature (4.2 mm) patients (P=0.67). Patients with a history of 1, 2, or 3+ dislocations had an average HSL volume of 1.3, 3.7, and 4.7 mm, respectively. The measurement method revealed excellent interreader reliability (P=0.00). There was a statistically significant difference between dislocation history group mean HSL volumes (P=0.019), as well as a statistically significant difference between the number of dislocations and lesion volume (P=0.011). CONCLUSIONS: HSLs can be effectively measured in adolescent patients using MR arthrography and patients with larger HSLs have more recurrent instability episodes, potentially meriting greater and earlier attention to the defect. LEVEL OF EVIDENCE: Prognostic/diagnostic study level IV.

United States medical school graduate interest in radiology residency programs as depicted by online search tools.

Recent media publications have indicated a tough job market in medical specialty positions for medical school graduates, specifically in the field of radiology. Internet search tools, such as Google Trends, have proved useful in the prediction of certain diseases on the basis of the search volume index for a specific term. The authors hypothesized that online search tools might be useful in the prediction of US medical school graduates' interest in residency positions in radiology. Google Trends indicated an increase over time in searches for "radiology salary" and a decrease over time in searches for "radiology residency." National Resident Matching Program results for diagnostic radiology showed an increase from 2004 to 2009 in the percentage of US graduates entering radiology but a dramatic drop from 2010 to 2013. This occurred even while the total number of US graduates active in the National Resident Matching Program increased. This finding might have been foretold on the basis of online query result trends. Online search data may be a useful insight into the interests of US medical school graduates and may be predictive of unfilled radiology residency positions and eventual increased shortages of community radiologists coming from US medical schools.

The bone scan.

Bone imaging continues to be the second greatest-volume nuclear imaging procedure, offering the advantage of total body examination, low cost, and high sensitivity. Its power rests in the physiological uptake and pathophysiologic behavior of 99m technetium (99m-Tc) diphosphonates. The diagnostic utility, sensitivity, specificity, and predictive value of 99m-Tc bone imaging for benign conditions and tumors was established when only planar imaging was available. Currently, nearly all bone scans are performed as a planar study (whole-body, 3-phase, or regional), with the radiologist often adding single-photon emission computed tomography (SPECT) imaging. Here we review many current indications for planar bone imaging, highlighting indications in which the planar data are often diagnostically sufficient, although diagnosis may be enhanced by SPECT. (18)F sodium fluoride positron emission tomography (PET) is also re-emerging as a bone agent, and had been considered interchangeable with 99m-Tc diphosphonates in the past. In addition to SPECT, new imaging modalities, including (18)F fluorodeoxyglucose, PET/CT, CT, magnetic resonance, and SPECT/CT, have been developed and can aid in evaluating benign and malignant bone disease. Because (18)F fluorodeoxyglucose is taken up by tumor cells and Tc diphosphonates are taken up in osteoblastic activity or osteoblastic healing reaction, both modalities are complementary. CT and magnetic resonance may supplement, but do not replace, bone imaging, which often detects pathology before anatomic changes are appreciated. We also stress the importance of dose reduction by reducing the dose of 99m-Tc diphosphonates and avoiding unnecessary CT acquisitions. In addition, we describe an approach to image interpretation that emphasizes communication with referring colleagues and correlation with appropriate history to significantly improve our impact on patient care.