The ABR 2021 Radiation Oncology Remote Examinations: Development, Administration, and Implications for the Future.

With the onset of the global coronavirus disease 2019 pandemic in early 2020, it became apparent that routine administration of the ABR Qualifying and Certifying Exams would be disrupted. Initial intent for postponement was later altered to a recognition that replacement of the existing delivery methodologies was essential. Herein, the authors describe the conceptualization, development, administration, and future implications of the new remote examination delivery platforms.

Pyelonephritis: radiologic-pathologic review.

Urinary tract infections are the most common urologic disease in the United States and annually account for over 7 million office and 1 million emergency department visits. In adults, diagnosis of urinary tract infection is typically based on characteristic clinical features and abnormal laboratory values. Imaging is usually reserved for patients who do not respond to therapy and for those whose clinical presentation is either atypical or potentially life threatening. Urinary tract infection typically originates in the urinary bladder; when it migrates to the kidney or is seeded there hematogenously, a tubulointerstitial inflammatory reaction ensues, involving the renal pelvis and parenchyma. The condition is characterized as pyelonephritis. Complicated and uncomplicated pyelonephritis, xanthogranulomatous pyelonephritis, and tuberculosis are all urinary tract infections for which imaging evaluation adds diagnostic information important for patient care. Computed tomography (CT), when performed before, immediately after, and at delayed intervals from contrast material injection, is the preferred modality for evaluating acute bacterial pyelonephritis. CT is also preferred over conventional radiography and ultrasonography (US) for assessing emphysematous pyelonephritis. Xanthogranulomatous pyelonephritis is a chronic granulomatous process, induced by recurrent bacterial urinary tract infection. Although US is useful in the diagnosis of this condition, CT is the main imaging tool, as it provides highly specific findings and accurate assessment of the extrarenal extent of disease, which is essential for surgical planning. The increasing prevalence of tuberculosis and continued emergence of antibiotic-resistant strains have significance for genitourinary radiologists, as the urinary tract is the most common extrapulmonary site of tuberculosis. Familiarity with the renal manifestations of the disease--pelvoinfundibular strictures, papillary necrosis, cortical low-attenuation masses, scarring, and calcification--will help in the diagnosis, even in the absence of documented pulmonary disease.

Computed tomographic appearance of urachal adenocarcinomas: review of 25 cases.

Twenty-five cases of surgically proven urachal carcinomas were retrospectively reviewed. The radiological archives at the Armed Forces Institute of Pathology were searched for cases of surgically proven urachal carcinomas that had a computed tomographic (CT) scan as a part of their radiologic evaluation. CT images from all cases were evaluated to determine tumor morphology, presence and localization of calcification, extent of bladder invasion and metastases. Tumor size at presentation averaged 6 cm. Twenty-one of 25 (84%) were mixed cystic solid lesions and 4/25 (16%) were completely solid. Calcifications were present in 18/25 (72%), with 11 peripherally located, 3 central only and 4 both. Bladder wall invasion was present in 23/25 (92%), but was seen as an intraluminal mass in only 13/25 (52%). The bulk of the mass was extravesicular in 22/25 (88%). Metastases were present in 12/25 (48%). Our series supports observations from other smaller series that a midline, calcified, supravesicular mass is highly suspicious, if not pathognomonic, for urachal carcinoma.