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1.
Stud Health Technol Inform ; 270: 203-207, 2020 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-32570375

RESUMEN

Radiology reports include various types of clinical information that are used for patient care. Reports are also expected to have secondary uses (e.g., clinical research and the development of decision support systems). For secondary use, it is necessary to extract information from the report and organize it in a structured format. Our goal is to build an application to transform radiology reports written in a free-text form into a structured format. To this end, we propose an end-to-end method that consists of three elements. First, we built a neural network model to extract clinical information from the reports. We experimented on a dataset of chest X-ray reports. Second, we transformed the extracted information into a structured format. Finally, we built a tool that enabled the transformation of terms in reports to standard forms. Through our end-to-end method, we could obtain a structured radiology dataset that was easy to access for secondary use.


Asunto(s)
Procesamiento de Lenguaje Natural , Redes Neurales de la Computación , Sistemas de Información Radiológica , Radiología , Humanos , Informe de Investigación , Programas Informáticos , Escritura
2.
Br J Radiol ; 93(1111): 20200055, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32462887

RESUMEN

OBJECTIVE: To assess the accuracy and agreement of radiology information system (RIS) kerma-area product (KAP) data with respect to automatically populated dose management system (DMS) data for digital radiography (DR). METHODS: All adult radiographic examinations over 12 months were exported from the RIS and DMS at three centres. Examinations were matched by unique identifier fields, and grouped by examination type. Each centre's RIS sample completeness was calculated, as was the percentage of the RIS examination KAP values within 5% of their DMS counterparts (used as an accuracy metric). For each centre, the percentage agreement between the RIS and DMS examination median KAP values was computed using a Bland-Altman analysis. At two centres, up to 42.5% of the RIS KAP units entries were blank or invalid; corrections were attempted to improve data quality in these cases. RESULTS: Statistically significant intersite variation was seen in RIS data accuracy and the agreement between the uncorrected RIS and DMS median KAP data, with a Bland-Altman bias of up to 11.1% (with a -31.7% to 53.9% 95% confidence interval) at one centre. Attempts to correct invalid KAP units increased accuracy but produced worse agreement at one centre, a slight improvement at another and no significant change in the third. CONCLUSION: The RIS data poorly represented the DMS data. ADVANCES IN KNOWLEDGE: RIS KAP data are a poor surrogate for DMS data in DR. RIS data should only be used in patient dose surveys with an understanding of its limitations and potential inaccuracies.


Asunto(s)
Intensificación de Imagen Radiográfica/normas , Sistemas de Información Radiológica/normas , Adulto , Sesgo , Recolección de Datos/métodos , Recolección de Datos/normas , Humanos , Dosis de Radiación , Protección Radiológica/normas , Estándares de Referencia , Sensibilidad y Especificidad
3.
Radiology ; 296(2): E97-E104, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32339082

RESUMEN

Background A categorical CT assessment scheme for suspicion of pulmonary involvement of coronavirus disease 2019 (COVID-19 provides a basis for gathering scientific evidence and improved communication with referring physicians. Purpose To introduce the COVID-19 Reporting and Data System (CO-RADS) for use in the standardized assessment of pulmonary involvement of COVID-19 on unenhanced chest CT images and to report its initial interobserver agreement and performance. Materials and Methods The Dutch Radiological Society developed CO-RADS based on other efforts for standardization, such as the Lung Imaging Reporting and Data System or Breast Imaging Reporting and Data System. CO-RADS assesses the suspicion for pulmonary involvement of COVID-19 on a scale from 1 (very low) to 5 (very high). The system is meant to be used in patients with moderate to severe symptoms of COVID-19. The system was evaluated by using 105 chest CT scans of patients admitted to the hospital with clinical suspicion of COVID-19 and in whom reverse transcription-polymerase chain reaction (RT-PCR) was performed (mean, 62 years ± 16 [standard deviation]; 61 men, 53 with positive RT-PCR results). Eight observers used CO-RADS to assess the scans. Fleiss κ value was calculated, and scores of individual observers were compared with the median of the remaining seven observers. The resulting area under the receiver operating characteristics curve (AUC) was compared with results from RT-PCR and clinical diagnosis of COVID-19. Results There was absolute agreement among observers in 573 (68.2%) of 840 observations. Fleiss κ value was 0.47 (95% confidence interval [CI]: 0.45, 0.47), with the highest κ value for CO-RADS categories 1 (0.58, 95% CI: 0.54, 0.62) and 5 (0.68, 95% CI: 0.65, 0.72). The average AUC was 0.91 (95% CI: 0.85, 0.97) for predicting RT-PCR outcome and 0.95 (95% CI: 0.91, 0.99) for clinical diagnosis. The false-negative rate for CO-RADS 1 was nine of 161 cases (5.6%; 95% CI: 1.0%, 10%), and the false-positive rate for CO-RADS category 5 was one of 286 (0.3%; 95% CI: 0%, 1.0%). Conclusion The coronavirus disease 2019 (COVID-19) Reporting and Data System (CO-RADS) is a categorical assessment scheme for pulmonary involvement of COVID-19 at unenhanced chest CT that performs very well in predicting COVID-19 in patients with moderate to severe symptoms and has substantial interobserver agreement, especially for categories 1 and 5. © RSNA, 2020 Online supplemental material is available for this article.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Tomografía Computarizada por Rayos X/normas , Adulto , Anciano , Comunicación , Femenino , Humanos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Países Bajos , Variaciones Dependientes del Observador , Pandemias , Sistemas de Información Radiológica , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Tomografía Computarizada por Rayos X/métodos
4.
Radiology ; 295(3): 593-605, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32208096

RESUMEN

Background Awareness of energy efficiency has been rising in the industrial and residential sectors but only recently in the health care sector. Purpose To measure the energy consumption of modern CT and MRI scanners in a university hospital radiology department and to estimate energy- and cost-saving potential during clinical operation. Materials and Methods Three CT scanners, four MRI scanners, and cooling systems were equipped with kilowatt-hour energy measurement sensors (2-Hz sampling rate). Energy measurements, the scanners' log files, and the radiology information system from the entire year 2015 were analyzed and segmented into scan modes, as follows: net scan (actual imaging), active (room time), idle, and system-on and system-off states (no standby mode was available). Per-examination and peak energy consumption were calculated. Results The aggregated energy consumption imaging 40 276 patients amounted to 614 825 kWh, dedicated cooling systems to 492 624 kWh, representing 44.5% of the combined consumption of 1 107 450 kWh (at a cost of U.S. $199 341). This is equivalent to the usage in a town of 852 people and constituted 4.0% of the total yearly energy consumption at the authors' hospital. Mean consumption per CT examination over 1 year was 1.2 kWh, with a mean energy cost (±standard deviation) of $0.22 ± 0.13. The total energy consumption of one CT scanner for 1 year was 26 226 kWh ($4721 in energy cost). The net consumption per CT examination over 1 year was 3580 kWh, which is comparable to the usage of a two-person household in Switzerland; however, idle state consumption was fourfold that of net consumption (14 289 kWh). Mean MRI consumption over 1 year was 19.9 kWh per examination, with a mean energy cost of $3.57 ± 0.96. The mean consumption for a year in the system-on state was 82 174 kWh per MRI examination and 134 037 kWh for total consumption, for an energy cost of $24 127. Conclusion CT and MRI energy consumption is substantial. Considerable energy- and cost-saving potential is present during nonproductive idle and system-off modes, and this realization could decrease total cost of ownership while increasing energy efficiency. © RSNA, 2020.


Asunto(s)
Conservación de los Recursos Energéticos/economía , Ahorro de Costo/economía , Imagen por Resonancia Magnética/economía , Radiología/economía , Tomografía Computarizada por Rayos X/economía , Alemania , Humanos , Sistemas de Información Radiológica , Suiza
5.
J Comput Assist Tomogr ; 44(2): 168-177, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32195795

RESUMEN

In this article, we aim to review Liver Imaging Reporting and Data System version 18 (LI-RADS v2018). Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy. Liver Imaging Reporting and Data System developed for standardizing interpreting, reporting, and data collection of HCC describes 5 major features for accurate HCC diagnosis and several ancillary features, some favoring HCC in particular or malignancy in general and others favoring benignity. Untreated hepatic lesions LI-RADS affords 8 unique categories based on imaging appearance on computed tomography and magnetic resonance imaging, which indicate the possibility of HCC or malignancy with or without tumor in vein. Furthermore, LI-RADS defines 4 treatment response categories for treated HCCs after different locoregional therapy. These continuous recent updates on LI-RADS improve the communication between the radiologists and the clinicians for better management and patient outcome.


Asunto(s)
Carcinoma Hepatocelular/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Sistemas de Información Radiológica , Humanos , Hígado/diagnóstico por imagen , Radiólogos
6.
J Comput Assist Tomogr ; 44(2): 188-192, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32195797

RESUMEN

OBJECTIVE: The aim of this study was to determine if texture analysis can classify liver observations likely to be hepatocellular carcinoma based on the Liver Imaging Reporting and Data System (LI-RADS) using single portal venous phase computed tomography. METHODS: This research ethics board-approved retrospective cohort study included 64 consecutive LI-RADS observations. Individual observation texture analysis features were compared using Kruskal-Wallis and 2 sample t tests. Logistic regression was used for prediction of LI-RADS group. Diagnostic accuracy was assessed using receiver operating characteristic curves and Youden method. RESULTS: Multiple texture features were associated with LI-RADS including the mean HU (P = 0.003), median (P = 0.002), minimum (P = 0.010), maximum (P = 0.013), standard deviation (P = 0.009), skewness (P = 0.007), and entropy (P < 0.001). On logistic regression, LI-RADS group could be predicted with area under the curve, sensitivity, and specificity of 0.98, 96%, and 100%, respectively. CONCLUSIONS: Texture analysis features on portal venous phase computed tomography can identify liver observations likely to be hepatocellular carcinoma, which may preclude the need to recall some patients for additional multiphase imaging.


Asunto(s)
Carcinoma Hepatocelular/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Sistemas de Información Radiológica , Tomografía Computarizada por Rayos X/métodos , Anciano , Estudios de Cohortes , Femenino , Humanos , Hígado/diagnóstico por imagen , Masculino , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad
8.
AJR Am J Roentgenol ; 214(5): 1152-1157, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32097031

RESUMEN

OBJECTIVE. The objective of this article is to assess radiologist concordance in characterizing thyroid nodules using the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS), focusing on the effect of radiologist experience on reader concordance. MATERIALS AND METHODS. Three experienced and three less experienced radiologists assessed 150 thyroid nodules using the TI-RADS lexicon. Percent concordance was determined for various endpoints. RESULTS. Interreader concordance for the five TI-RADS categories was 87.2% for shape, 81.2% for composition, 76.1% for echogenicity, 72.9% for margins, and 69.8% for echogenic foci. Concordance for individual features was 96.3% for rim calcifications, 90.8% for macrocalcifications, 90.1% for spongiform, 83.5% for comet tail artifact, and 77.7% for punctate echogenic foci. Concordance for the TI-RADS level and recommendation for fine-needle aspiration (FNA) were 50.4% and 78.9%, respectively. Concordance was significantly (p < 0.05) higher for less experienced readers in identifying margins (84.3% vs 67.4%), echogenic foci (76.9% vs 69.3%), comet tail artifact (89.6% vs 79.2%), and punctate echogenic foci (85.3% vs 75.5%), and lower for peripheral rim calcifications (95.0% vs 97.8 %), but was not different (p > 0.05) for the remaining categories and features. CONCLUSION. A range of TI-RADS categories, features, and recommendations for FNA had generally moderate interreader agreement among six radiologists. Our results show that concordance for numerous characteristics was significantly higher for the less experienced versus the more experienced readers. These results suggest that less experienced readers relied more on the explicit TI-RADS criteria, whereas the experienced radiologists partially relied on their accumulated experience when forming impressions. However, the overall TI-RADS level and recommendation for FNA were unaffected, supporting the robustness of the TI-RADS lexicon and its continued use in practice.


Asunto(s)
Competencia Clínica , Radiólogos/normas , Sistemas de Información Radiológica , Nódulo Tiroideo/diagnóstico por imagen , Ultrasonografía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Artefactos , Biopsia con Aguja Fina , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Estudios Retrospectivos , Nódulo Tiroideo/patología
9.
AJR Am J Roentgenol ; 214(4): 835-842, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32023118

RESUMEN

OBJECTIVE. The objective of this study was to assess impact of a report template quality improvement (QI) initiative on use of preferred phrases for communicating normal findings in structured abdominal CT and MRI reports. SUBJECTS AND METHODS. This prospective QI initiative, designed to decrease use of equivocal phrases and increase use of preferred and acceptable phrases (defined by multidisciplinary experts including patient advocates) in radiology reports, was performed in an academic medical center with over 800,000 annual radiologic examinations and was exempt from institutional review board approval. The intervention populated the preferred term "normal" (default) and acceptable specified pertinent negative phrases (pick-list option) when describing abdominal organ subheadings (liver, pancreas, spleen, adrenal glands, kidneys) within the "Findings" heading of abdominal CT and MRI report templates. We tabulated frequencies of the term "normal", specified pertinent negatives, and equivocal phrases in 21,629 reports before (June 1, 2017, to February 28, 2018) and 23,051 reports after (April 1, 2018, to December 31, 2018) the intervention using natural language processing and recorded trainee participation in report generation. We assessed intervention impact using statistical process control (SPC) charts and the Fisher exact test. RESULTS. Equivocal phrases were used less frequently in abdominal CT and MRI reports for both attending radiologists and trainees after the intervention (p < 0.05, SPC). Use of the term "normal" increased for reports generated by attending radiologists alone but decreased for reports created with trainee participation (p < 0.05, SPC). Frequency of pertinent negatives increased for reports with trainee participation (p < 0.05, SPC). CONCLUSION. A QI intervention decreased use of equivocal terms and increased use of preferred and acceptable phrases when communicating normal findings in abdominal CT and MRI reports.


Asunto(s)
Control de Formularios y Registros/normas , Imagen por Resonancia Magnética , Mejoramiento de la Calidad , Terminología como Asunto , Tomografía Computarizada por Rayos X , Humanos , Estudios Prospectivos , Sistemas de Información Radiológica
11.
AJR Am J Roentgenol ; 214(4): 754-760, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31990214

RESUMEN

OBJECTIVE. The purpose of this study was to introduce a 24-hour teleradiology service for cruise ships as a novel concept in maritime telemedicine. SUBJECTS AND METHODS. One cruise ship equipped with a mobile radiography unit and digital storage imaging plates was involved in this pilot study. Radiographs were transmitted via satellite internet to a tertiary hospital on shore for image interpretation by expert radiologists. Use of a virtual private network (VPN) enabled secure data transfer. Radiographs and patient data were automatically integrated into the PACS and radiology information system of the radiology department at the hospital. Images were analyzed by the staff radiologist at the hospital, and reports were immediately returned via e-mail through the VPN tunnel. RESULTS. Seventy-five radiographs of 47 patients were obtained on board within 2 months. All datasets were successfully transmitted. Most of the examinations (35 [≈ 75%]) were skeletal radiographs; the other 12 (≈ 25%) were chest radiographs. The turnaround time for the radiology reports was within 30 minutes in 43 cases (≈ 92%). In four cases (≈ 8%), delay was due to technical and organizational issues at the tertiary hospital. CONCLUSION. With the objective of supporting ship physicians with expert analyses of radiographs, a secure and stable method of image and radiology report transmission between an onboard hospital and a land-based radiology department was established.


Asunto(s)
Navíos , Telerradiología/organización & administración , Adulto , Anciano , Seguridad Computacional , Correo Electrónico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Sistemas de Información Radiológica , Comunicaciones por Satélite
12.
Radiology ; 294(1): 168-185, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31687921

RESUMEN

The Ovarian-Adnexal Reporting and Data System (O-RADS) US risk stratification and management system is designed to provide consistent interpretations, to decrease or eliminate ambiguity in US reports resulting in a higher probability of accuracy in assigning risk of malignancy to ovarian and other adnexal masses, and to provide a management recommendation for each risk category. It was developed by an international multidisciplinary committee sponsored by the American College of Radiology and applies the standardized reporting tool for US based on the 2018 published lexicon of the O-RADS US working group. For risk stratification, the O-RADS US system recommends six categories (O-RADS 0-5), incorporating the range of normal to high risk of malignancy. This unique system represents a collaboration between the pattern-based approach commonly used in North America and the widely used, European-based, algorithmic-style International Ovarian Tumor Analysis (IOTA) Assessment of Different Neoplasias in the Adnexa model system, a risk prediction model that has undergone successful prospective and external validation. The pattern approach relies on a subgroup of the most predictive descriptors in the lexicon based on a retrospective review of evidence prospectively obtained in the IOTA phase 1-3 prospective studies and other supporting studies that assist in differentiating management schemes in a variety of almost certainly benign lesions. With O-RADS US working group consensus, guidelines for management in the different risk categories are proposed. Both systems have been stratified to reach the same risk categories and management strategies regardless of which is initially used. At this time, O-RADS US is the only lexicon and classification system that encompasses all risk categories with their associated management schemes.


Asunto(s)
Neoplasias Ováricas/diagnóstico por imagen , Sistemas de Información Radiológica , Ultrasonografía/métodos , Enfermedades de los Anexos , Femenino , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Medición de Riesgo , Sociedades Médicas , Estados Unidos
13.
AJR Am J Roentgenol ; 214(4): 727-735, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31770023

RESUMEN

OBJECTIVE. As health care moves into a new era of increasing information vulnerability, radiologists should understand that they may be using systems that are exposed to altered data or data that contain malicious elements. This article explains the vulnerabilities of DICOM images and discusses requirements to properly secure these images from cyberattacks. CONCLUSION. There is an important need to properly secure DICOM images from attacks and tampering. The solutions described in this article will go a long way to achieving this goal.


Asunto(s)
Seguridad Computacional , Sistemas de Información Radiológica , Robo , Confidencialidad , Humanos , Almacenamiento y Recuperación de la Información
14.
AJR Am J Roentgenol ; 214(3): 613-617, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31846375

RESUMEN

OBJECTIVE. The objective of this article is to assess the impact of integrating peer review in PACS on the reporting of discrepancies. Our hypothesis is that a PACS-integrated machine-randomized and semiblinded peer review tool leads to an increase in discrepancies reported. MATERIALS AND METHODS. A PACS tool was implemented to prompt radiologists to perform peer review of prior comparison studies in a randomized fashion. The reviewed radiologist's name was omitted from the prior report in PACS. Before this implementation, radiologists entered peer reviews directly on the RADPEER website. Three academic subspecialty sections comprising 24 radiologists adopted the tool (adopters group). Three sections comprising 14 radiologists did not adopt the tool (nonadopters group). Peer review submissions were analyzed for 4 months before and 4 months after the implementation. The mean rate of significant discrepancies (RADPEER score 2b or higher) reported per radiologist was calculated and the discrepancy rates of the periods before and after the implementation were compared. RESULTS. The mean significant discrepancy rate reported per radiologist in the adopters group increased from 0.19% ± 0.46% (SD) before the implementation to 0.93% ± 1.45% after implementation (p = 0.01). No significant discrepancies were reported by the nonadopters group in either period. CONCLUSION. In this single institutional retrospective analysis, integrating peer review in PACS resulted in a fivefold increase in reported significant discrepancies. These results suggest that peer review data are influenced by the design of the tool used including PACS integration, randomization, and blinding.


Asunto(s)
Errores Diagnósticos/prevención & control , Errores Diagnósticos/estadística & datos numéricos , Revisión por Pares/métodos , Competencia Profesional/estadística & datos numéricos , Sistemas de Información Radiológica , Humanos , Garantía de la Calidad de Atención de Salud , Estudios Retrospectivos
15.
Eur J Radiol ; 121: 108704, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31669798

RESUMEN

PURPOSE: To compare the diagnostic performance of PI-RADS v2 and v2.1 for detecting transition zone prostate cancer (TZPC) on multiparametric prostate MRI (mpMRI). METHOD: Fifty-eight patients with elevated PSA levels underwent mpMRI at 3 T including T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), and subsequent MRI-transrectal ultrasonography fusion-guided prostate-targeted biopsy (MRGB). The standard of reference was MRGB-derived histopathology. Two readers independently assessed each TZ lesion, assigning a score of 1-5 for T2WI, a score of 1-5 for DWI, and the overall PI-RADS assessment category according to PI-RADS v2 and v2.1. The diagnostic performance of the two methods was compared in terms of inter-reader agreement, diagnostic sensitivity, diagnostic specificity, and area under the ROC curve (AUC). RESULTS: Of the 58 patients, 26 were diagnosed with PC (GS = 3 + 3, n = 9; GS = 3 + 4, n = 9; GS = 3 + 5, n = 1; GS = 4 + 3, n = 4; GS = 4 + 4, n = 3) and 32 with benign lesions. Regarding inter-reader agreement of overall PI-RADS assessment category, the kappa value was 0.580 for v2 and 0.645 for v2.1. For both readers, there was no difference in diagnostic sensitivity between the versions (p ≥ 0.500). For reader 1, the diagnostic specificity was higher for v2.1 (p = 0.002), and was similar for reader 2 (p = 1.000). For both readers, AUC tended to be higher for v2.1 than for v2, but the difference was not significant (0.786 vs. 0.847 for reader 1, p = 0.052; and 0.808 vs. 0.858 for reader 2, p = 0.197). CONCLUSIONS: These results suggest that compared with PI-RADS v2, PI-RADS v2.1 could be preferable for evaluating TZ lesions.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Neoplasias de la Próstata/diagnóstico por imagen , Sistemas de Información Radiológica , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Imagen de Difusión por Resonancia Magnética , Humanos , Biopsia Guiada por Imagen , Masculino , Persona de Mediana Edad , Próstata/diagnóstico por imagen , Próstata/patología , Neoplasias de la Próstata/patología , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad , Ultrasonografía Intervencional/métodos
16.
Eur J Radiol ; 121: 108711, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31677544

RESUMEN

PURPOSE: We developed and validated a radiomic model based on mammography and assessed its value for predicting the pathological diagnosis of Breast Imaging Reporting and Data System (BI-RADS) category 4 calcifications. MATERIALS AND METHODS: Patients with a total of 212 eligible calcifications were recruited (159 cases in the primary cohort and 53 cases in the validation cohort). In total, 8286 radiomic features were extracted from the craniocaudal (CC) and mediolateral oblique (MLO) images. Machine learning was used to select features and build a radiomic signature. The clinical risk factors were selected from the independent clinical factors through logistic regression analyses. The radiomic nomogram incorporated the radiomic signature and an independent clinical risk factor. The diagnostic performance of the radiomic model and the radiologists' empirical prediction model was evaluated by the area under the receiver operating characteristic curve (AUC). The differences between the various AUCs were compared with DeLong's test. RESULTS: Six radiomic features and the menopausal state were included in the radiomic nomogram, which discriminated benign calcifications from malignant calcifications with an AUC of 0.80 in the validation cohort. The difference between the classification results of the radiomic nomogram and that of radiologists was significant (p < 0.05). Particularly for patients with calcifications that are negative on ultrasounds but can be detected by mammography (MG+/US- calcifications), the identification ability of the radiomic nomogram was very strong. CONCLUSIONS: The mammography-based radiomic nomogram is a potential tool to distinguish benign calcifications from malignant calcifications.


Asunto(s)
Enfermedades de la Mama/diagnóstico por imagen , Calcinosis/diagnóstico por imagen , Mamografía/métodos , Sistemas de Información Radiológica , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Estudios de Cohortes , Femenino , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Curva ROC , Reproducibilidad de los Resultados , Estudios Retrospectivos
17.
Nihon Hoshasen Gijutsu Gakkai Zasshi ; 75(11): 1347-1354, 2019.
Artículo en Japonés | MEDLINE | ID: mdl-31748461

RESUMEN

The safety management information related to heat generation in magnetic resonance imaging (MRI) examinations includes the specific absorption rate (SAR), the root mean square (RMS) of the MRI effective component of the B1 field (B1+rms), and imaging time, which must be set appropriately before an MRI examination. However, unlike image attributes and data, these three parameters do not require any image storage; therefore, information collection and confirmation post-inspection are difficult. Therefore, in this study, we used Digital Imaging and Communications in Medicine of SAR and imaging time using the overlay function of the picture archiving and communication systems (PACS) to confirm the specific absorption rate B1+rms and imaging time post-inspection. The medicine identification tag information was displayed on the PACS viewer. For some imaging times, the console display during scanning and the PACS viewer display did not match. However, the SAR console display during scanning and the PACS viewer display matched well, thereby rendering it easier to manage safety in MRI examinations.


Asunto(s)
Gestión de la Información , Sistemas de Información Radiológica , Calor , Imagen por Resonancia Magnética
18.
BMC Med Educ ; 19(1): 383, 2019 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-31638969

RESUMEN

BACKGROUND: Medical education in China is in a transitional period, from passive learning models to experiential education. We modified an experiential education method for radiology education. The aim of this study is to evaluate the effect of this method on undergraduate radiology education. METHOD: With the help of the picture archiving and communication system (PACS) and RadiAnt DICOM Viewer, we modified an experiential education method that simulates similar working conditions for undergraduate medical students to formulate radiology diagnosis similar to clinical radiologists. A total of 101 students were allocated into either the experiential education group or the control group. The final examination scores and a 5-point Likert scale self-assessment questionnaire of radiologic skills were collected from all the students as an objective assessment and a subjective assessment respectively. A questionnaire was also used to assess the satisfaction with the experiential model in the experiential education group. Mann-Whitney U test was used to compare the ranked data, and t-tests were used to compare the numeric data. RESULTS: The experiential education group demonstrated significantly higher scores (7.4 ± 1.3) compared to the control group (6.7 ± 1.5, p < 0.05) in the question type "description and diagnosis". The self-assessment questionnaire indicated that the experiential education was related to increased familiarity with the diagnosis thinking principle and the sequences and reconstruction methods of computer tomography (CT) imaging, which also strengthen participants' self-confidence to perform future clinical work (p < 0.05). The self-assessment questionnaire in the experiential education group showed that the majority of students were satisfied with the organization (82.5%), interactivity (85%) and quality (85%) of the learning activity. Most students found this model of learning to be helpful for studying radiology (85%) and for understanding anatomy (90%). CONCLUSION: Compared with the traditional radiology education approach, the experiential education method showed greater efficacy in improving students' analysis and diagnostic skills and their self-confidence.


Asunto(s)
Competencia Clínica/estadística & datos numéricos , Educación de Pregrado en Medicina/métodos , Aplicaciones de la Informática Médica , Modelos Educacionales , Aprendizaje Basado en Problemas , Sistemas de Información Radiológica , Radiología/educación , Estudiantes de Medicina , China/epidemiología , Femenino , Humanos , Masculino , Sistemas de Información Radiológica/normas , Programas Informáticos , Adulto Joven
19.
Eur J Radiol ; 120: 108661, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31610322

RESUMEN

Radiologists often encounter imaging requisitions that lack important information needed for accurate diagnostic studies. Reason for exam Imaging Reporting and Data System (RI-RADS) is proposed as a grading system for evaluation of the quality of clinically pertinent information provided in imaging requisitions. Three categories of information are suggested as key indicators of quality: impression, clinical findings, and the diagnostic question. This scheme is intended to improve the quality of imaging requisitions and overall patient care.


Asunto(s)
Radiografía/normas , Sistemas de Información Radiológica/normas , Sistemas de Datos , Errores Diagnósticos/prevención & control , Humanos , Registros Médicos/normas , Mejoramiento de la Calidad , Radiología/normas , Proyectos de Investigación
20.
Eur J Radiol ; 120: 108685, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31606712

RESUMEN

PURPOSE: This study explored the interreader agreement and diagnostic performance of contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS). METHODS: Between January 2014 and December 2017, 1366 patients at risk for hepatocellular carcinoma (HCC) who underwent CEUS were included in this retrospective study. Four ultrasound physicians rated the HCC likelihood of focal liver lesions (FLLs) using CEUS LI-RADS v2017. Interreader agreement on CEUS LI-RADS categories and major features (arterial phase hyperenhancement (APHE), washout appearance) were assessed using weighted kappa statistics (κ). Diagnostic performance was described by sensitivity, specificity, PPV and NPV, +LR, -LR. RESULTS: The interreader agreement (κ) for CEUS LI-RADS categories, APHE, and washout appearance ranged from 0.61 to 0.73, 0.65 to 0.83, and 0.58 to 0.71, respectively. Interreader agreement for LI-RADS categories and APHE were almost substantial between FLLs <2 cm, ≥2 cm, <5 cm; interreader agreement for major features were fair to substantial for FLLs ≥5 cm. The accuracy, PPV and + LR for HCC and malignancy in FLLs <2 cm, ≥2 cm, <5 cm, ≥5 cm were high, with values of 84.7% to 91.9%, 90.2% to 94.2%, and 2.2 to 8.0, respectively. CEUS LI-RADS had the highest specificity for HCC (90.2%) and malignancy (90.9%) diagnosis for FLLs <2 cm and <5 cm, respectively; specificity was lowest for HCC (54.7%) and malignancy (68.3%) diagnosis for FLLs ≥5 cm. CONCLUSIONS: CEUS LI-RADS is a good standardized categorization system for high-risk patients, and the combination of two or three LR-M features may improve the true-negative classification of HCC diagnosis.


Asunto(s)
Carcinoma Hepatocelular/diagnóstico por imagen , Medios de Contraste , Aumento de la Imagen/métodos , Neoplasias Hepáticas/diagnóstico por imagen , Ultrasonografía/métodos , Femenino , Humanos , Hígado/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Sistemas de Información Radiológica , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad
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