A trend, analysis, and solution on women's representation in diagnostic radiology in North America: a narrative review.

Despite the demonstrated benefits of gender diversity in medicine, women in Radiology in North America are still underrepresented. We reviewed the literature to highlight the current status of women in Radiology in North America, identify the underlying causes of the gender gap, and provide potential strategies to close this gap. We conducted a narrative literature review using the terms ("Gender Disparity" OR "Gender Inequality") AND ("Radiology Department" OR "Radiology Residency"), searching data from April 2000 to April 2022 in Ovid Medline, Embase, PubMed, and Scopus. Our results indicate that Radiology in North America lacks gender diversity in its subspecialties, academic leadership, and research productivity, which the COVID-19 pandemic has further exacerbated. Challenges stemming from a dearth of women role models, limited preclinical contact, and a high rate of burnout contribute to the current gender inequality. Several complementary and supplementary steps can enhance gender diversity in Radiology. These include increasing education and exposure to Radiology at earlier stages and optimizing mentorship opportunities to attract a more diverse pool of talent to the discipline. In addition, supporting resident parents and enhancing the residency program's culture can decrease the rate of burnout and encourage women to pursue careers and leadership positions in Radiology.

Acquisition time, radiation dose, subjective and objective image quality of dual-source CT scanners in acute pulmonary embolism: a comparative study.

OBJECTIVES: To compare the scan acquisition time, radiation dose, subjective and objective image quality of two dual-source CT scanners (DSCT) for detection of acute pulmonary embolism. METHODS: Two hundred twenty-one scans performed on the 2nd-generation DSCT and 354 scans on the 3rd-generation DSCT were included in this large retrospective study. In a randomized blinded design, two radiologists independently reviewed the scans using a 5-point Likert scale. Radiation dose and objective image quality parameters were calculated. RESULTS: Mean acquisition time was significantly lower in the 3rd-generation DSCT (2.81 s ± 0.1 in comparison with 9.7 s ± 0.15 [mean ± SD] respectively; p < 0.0001) with the 3rd generation 3.4 times faster. The mean subjective image quality score was 4.33/5 and 4/5 for the 3rd- and 2nd-generation DSCT respectively (p < 0.0001) with strong interobserver reliability agreement. DLP, CTDIvol, and ED were significantly lower in the 3rd than the 2nd generation (175.6 ± 63.7 mGy cm; 5.3 ± 1.9 mGy and 2.8 ± 1.2 mSv in comparison with 266 ± 255 mGy.cm; 7.8 ± 2.2 mGy and 3.8 ± 4.3 mSv). Noise was significantly lower in the 3rd generation (p < 0.01). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM), a dose-insensitive index for CNR, were significantly higher in the 3rd-generation DSCT (33.5 ± 23.4; 29.0 ± 21.3 and 543.7 ± 1037 in comparison with 23.4 ± 17.7; 19.4 ± 16.0 and 170.5 ± 284.3). CONCLUSION: Objective and subjective image quality are significantly higher on the 3rd-generation DSCT with significantly lower mean acquisition time and radiation dose. KEY POINTS: • The 3rd-generation DSCT scanner provides an improved image quality, less perceived artifacts, and lower radiation dose in comparison with the 2nd-generation DSCT, when operating in dual-energy (DE) mode. • The 3.4-times-faster 3rd-generation DSCT scanner can be of particular value in patients with chronic lung diseases or breathing difficulties that prevent adequate breathhold.

Lack of Gender Disparity Among Administrative Leaders of Canadian Health Authorities.

Background: Gender distribution within the managing bodies of the Canadian health authorities has not been studied despite their integral role in the health care system. The purpose of this study is to quantify gender differences and to craft a geographic gender analysis of such distribution. Methods: Retrospective data collection of all Canadian health authorities at the provincial, territorial, regional, and first nations levels was conducted. The dependent variable was gender, and other covariates, where applicable, included province/territory, region, leadership position, education (PhD or Master's), honorary degree, and primary occupation. Any member within the executive managing body or board of directors of a Canadian health authority was included, unless their gender could not be determined, in which case they were excluded. Results: Quantitative analysis of the 67 health authorities revealed 1346 individuals with identifiable gender (710 women; 636 men). Thematic distribution showed no significant difference in the gender distribution by provinces/territories (chi square = 14.248; p = 0.28), by leadership position (chi square = 1.88; p = 0.75), by education (chi square = 1.85; p = 0.17), or by primary occupation (chi square = 1.53; p = 0.46). Conclusion: The overall number of females exceeded that of males and there were no gender disparities. Critical analysis of probable causes was discussed. Further studies should be conducted to examine the policies and programs within the Canadian health authorities that successfully tackle the retention, recruitment, and promotion of females.

Leadership Gender Disparity Within Research-Intensive Medical Schools: A Transcontinental Thematic Analysis.

BACKGROUND: The underrepresentation of women in senior leadership positions of academic medicine continues to prevail despite the ongoing efforts to advance gender parity. Our aim was to compare the extent of gender imbalance in the leadership of the top 100 medical schools and to critically analyze the contributing factors through a comprehensive theoretical framework. METHODS: We adopted the theoretical framework of the Systems and Career Influences Model. The leadership was classified into four tiers of leadership hierarchy. Variables of interest included gender, h-index, number of documents published, total number of citations, and number of years in active research. A total of 2448 (77.59%) men and 707 (22.41%) women met the inclusion criteria. RESULTS: Male majority was found in all regions with a significant difference in all levels of leadership (chi square = 91.66; P value = .001). Women had a lower mean h-index across all positions in all regions, and when we adjusted for number of years invested, M Index for women was still significantly lower than men (T test = 6.52; P value = .02). DISCUSSION: Organizational and individual influences are transcontinental within the top 100 medical school leadership hierarchy. Those factors were critically assessed through in-depth analysis of the Systems and Career Influences Model. Evidence-driven actionable recommendations to remedy those influences were outlined.

Dual-Energy CT in Differentiating Nonperforated Gangrenous Appendicitis From Uncomplicated Appendicitis.

OBJECTIVE: The hypothesis of this study was that the use of dual-energy spectral techniques in CT can improve accuracy in the diagnosis of acute gangrenous appendicitis. MATERIALS AND METHODS: This retrospective study included 209 patients with a pathologic diagnosis of appendicitis. Two board-certified abdominal radiologists reviewed 120-kV simulated images, 40-keV virtual monoenergetic images, and color-coded iodine overlay images. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), accuracy, and interobserver agreement were calculated for each set of images. RESULTS: Forty-four patients (21.0%) had histopathologic results positive for gangrenous appendicitis. The sensitivity of 40-kV virtual monoenergetic imaging was 100% (44/44); specificity, 81.2% (134/165); PPV, 58.7% (44/75); NPV, 100% (134/134); accuracy, 85.2%; and interobserver agreement, 0.99. The corresponding values for the iodine overlay imaging datasets were 100% (44/44), 80.0% (132/165), 57.1% (44/77), 100% (132/132), 84.2%, and 0.99 and for 120-kV simulated imaging were 22.7% (10/44), 96.4% (159/165), 62.5% (10/16), 82.4% (159/193), 77.5%, and 0.93. All cases of gangrenous appendicitis had true-positive results of virtual monoenergetic and iodine overlay imaging. There were no false-negative results of virtual monoenergetic or iodine overlay imaging. CONCLUSION: In cases of suspected appendicitis, dual-energy CT that includes virtual monoenergetic and iodine overlay imaging is accurate for confirming and excluding the presence of gangrenous appendicitis with high sensitivity and specificity.

What Are the Expected Findings on Follow-up Computed Tomography Angiogram in Post-traumatic Patients With Blunt Cerebrovascular Injury?

PURPOSE: Blunt cerebrovascular injury (BCVI) is a rare but potentially devastating diagnosis. Our study establishes the temporal changes and findings on follow-up imaging. METHODS: For this retrospective, institutional review board-approved study, the hospital trauma registry was queried for all severely injured polytrauma patients who underwent computed tomography angiogram (CTA) scans in the emergency department between January 1, 2010, and December 31, 2016, with injury severity score ≥16, yielding 3747 patients. A total of 128 patients had a follow-up CTA for BCVI. The grade, location, and outcomes of injuries on follow-up imaging were studied. RESULTS: A vehicular collision was the most common mechanism of injury (75%). The majority of patients (61%) had a Glasgow Coma Scale of 10-15. Vertebral fractures were the most common associated injury (57%). The overall incidence of BCVI in our study population was 4.8%. On the initial CTA, 50% of injuries were grade 1, 25.4% were grade 2, 7% were grade 3, 17% were grade 4, and 0.6% were grade 5. For the different grades of injuries, improvement has been documented in 44% with complete healing in 34%, while 51% of injuries remained unchanged from the initial scan. Only 5% progressed to a higher-grade injury. Twelve patients developed strokes with an incidence of 9.4% in patients with a follow-up CTA. CONCLUSIONS: This study can help increase the awareness of radiologists about the evolution patterns of different grades of BCVIs on follow-up CTA for severely injured posttraumatic patients.