Flexible work arrangements and their impact on women in radiology: RSNA 2021 panel discussion summary sponsored by AAWR and more.

There is an ongoing trend in the direction of flexible work arrangements in which employees can decide where and when to work. Multiple studies have demonstrated a significant decrease in associated job-related stress, improved job satisfaction, job autonomy, and collaboration when flexible work arrangements exist. However, some have reported increased workload and home spillover to work.1 The American Association for Women in Radiology (AAWR) convened a panel of radiologist presenters with diverse backgrounds who shared their own experiences with flexible work arrangements at the Radiological Society of North America (RSNA) 2021 Scientific Assembly and Annual Meeting. This manuscript summarizes the discussion and reviews various aspects of workplace flexibility. The RSNA 2021 AAWR-sponsored panel on workplace flexibility reviewed the current state of different work arrangements available for radiologists and addressed future strategies for implementing workplace flexibility. The panelists addressed the imperatives and key factors for the availability of diverse opportunities and ways to foster future opportunities. Matters discussed included differences in the availability of flexible work arrangements in the healthcare system compared to other industries, normalizing flexible work arrangements at the organization level, underutilization of currently available flexible work arrangements, part-time positions and stigma associated with them, thriving in a part-time capacity, workplace flexibility options for radiology residents and fellows and successfully implementing workplace flexibility at institutions. The panel ended with a call to action to develop toolkits with effective resources to support implementing flexible workplace opportunities.

Characterizing Indeterminate Renal Masses with Molecular Imaging: the Role of 99mTc-MIBI SPECT/CT.

PURPOSE OF REVIEW: The majority of enhancing renal masses cannot be characterized through imaging as malignant or benign; however, such characterization could save patients from unnecessary surgery and/or biopsy and associated morbidity. Herein, we review the recent literature on the emerging use of 99mTc-MIBI SPECT/CT in preoperative differentiation of enhancing renal masses. RECENT FINDINGS: Recent reports have shown that 99mTc-MIBI SPECT/CT imaging can differentiate mitochondrial-rich, benign, or indolent renal masses from renal cell carcinoma. These studies demonstrate good correlation between a positive 99mTc-MIBI SPECT/CT scan and a pathologically proven diagnosis of renal oncocytoma and hybrid oncocytic/chromophobe tumor. In addition, there is excellent correlation between a negative scan and a diagnosis of clear cell subtype of renal cell carcinoma. Preoperative 99mTc-MIBI SPECT/CT offers a non-invasive method for differentiating renal lesions with low aggressiveness from other RCCs, in particular, clear cell renal cell carcinoma.

Retained surgical item identification on imaging studies: a training module for radiology residents.

PURPOSE: Many hospitals experience one or more retained surgical item events per year, with risk of patient morbidity and medicolegal consequences. We hypothesized that the confidence and performance of the radiologist would be enhanced by prior training in retained surgical item detection and by prior exposure to commonly employed surgical instruments and devices. METHODS: A training module for radiology residents was created through literature review, expert consultation, and imaging of commonly employed surgical instruments and devices. A survey assessing resident command of background knowledge, policy, and image-based retained surgical item questions was created. Additionally resident confidence for hospital policy and retained surgical item identification was assessed. A pre-module survey and confidence questionnaire were administered to first- through fourth- year residents. For one month, the training module was available online for independent review. Subsequently, a post-module survey and confidence questionnaire were completed by participants. T tests were performed to evaluate pre- and posttest means for survey performance and confidence questions. RESULTS: Mean post-module survey performance significantly improved compared with pre-module performance. Mean confidence levels for ability to incidentally identify a retained surgical item on a radiograph obtained for another indication and current understanding of the institution's policy regarding retained surgical items were also significantly increased. CONCLUSION: The knowledge base, diagnostic performance, and confidence of radiology residents were significantly enhanced by online teaching module training in retained surgical item detection.

Visual- and saccade-related signals in the primate inferior colliculus.

The inferior colliculus (IC) is normally thought of as a predominantly auditory structure because of its early position in the ascending auditory pathway just before the auditory thalamus. Here, we show that a majority of IC neurons (64% of 180 neurons) in awake monkeys carry visual- and/or saccade-related signals in addition to their auditory responses (P < 0.05). The response patterns involve primarily excitatory visual responses, but also increased activity time-locked to the saccade, slow rises in activity time-locked to the onset of the visual stimulus, and inhibitory responses. The presence of these visual-related signals suggests that the IC plays a role in integrating visual and auditory information. More broadly, our results show that interactions between sensory pathways can occur at very early points in sensory processing streams, which implies that multisensory integration may be a low-level rather than an exclusively high-level process.

The "other" transformation required for visual-auditory integration: representational format.

Multisensory integration of spatial signals requires not only that stimulus locations be encoded in the same spatial reference frame, but also that stimulus locations be encoded in the same representational format. Previous studies have addressed the issue of spatial reference frame, but representational format, particularly for sound location, has been relatively overlooked. We discuss here our recent findings that sound location in the primate inferior colliculus is encoded using a "rate" code, a format that differs from the place code used for representing visual stimulus locations. Possible mechanisms for transforming signals from rate-to-place or place-to-rate coding formats are considered.

Effects of reward and behavioral context on neural activity in the primate inferior colliculus.

Neural activity in the inferior colliculus (IC) likely plays an integral role in the processing of various auditory parameters, such as sound location and frequency. However, little is known about the extent to which IC neural activity may be influenced by the context in which sounds are presented. In this study, we examined neural activity of IC neurons in the rhesus monkey during an auditory task in which a sound served as a localization target for a saccade. Correct performance was rewarded, and the magnitude of the reward was varied in some experiments. Neural activity was also assessed during a task in which the monkey maintained fixation of a light while ignoring the sound, as well as when sounds were presented in the absence of any task. We report that neural activity increased late in the trial in the saccade task in 58% of neurons and that the level of activity throughout the trials could be modulated by reward magnitude for many neurons. The late-trial neural activity similarly increased in the fixation task in 39% of the neurons tested for this task but was not observed when sounds were presented in the absence of a behavioral task and reward. Together, these results suggest that a reward-related signal influences neural activity in the IC.

Long lasting attenuation by prior sounds in auditory cortex of awake primates.

How the brain responds to sequences of sounds is a question of great relevance to a variety of auditory perceptual phenomena. We investigated how long the responses of neurons in the primary auditory cortex of awake monkeys are influenced by the previous sound. We found that responses to the second sound of a two-sound sequence were generally attenuated compared to the response that sound evoked when it was presented first. The attenuation remained evident at the population level even out to inter-stimulus intervals (ISIs) of 5 s, although it was of modest size for ISIs >2 s. Behavioral context (performance versus non-performance of a visual fixation task during sound presentation) did not influence the results. The long time course of the first sound's influence suggests that, under natural conditions, neural responses in auditory cortex are rarely governed solely by the current sound.

Representation of eye position in primate inferior colliculus.

We studied the representation of eye-position information in the primate inferior colliculus (IC). Monkeys fixated visual stimuli at one of eight or nine locations along the horizontal meridian between -24 and 24 degrees while sounds were presented from loudspeakers at locations within that same range. Approximately 40% of our sample of 153 neurons showed statistically significant sensitivity to eye position during either the presentation of an auditory stimulus or in the absence of sound (Bonferroni corrected P < 0.05). The representation for eye position was predominantly monotonic and favored contralateral eye positions. Eye-position sensitivity was more prevalent among neurons without sound-location sensitivity: about half of neurons that were insensitive to sound location were sensitive to eye position, whereas only about one-quarter of sound-location-sensitive neurons were also sensitive to eye position. Our findings suggest that sound location and eye position are encoded using independent but overlapping rate codes at the level of the IC. The use of a common format has computational advantages for integrating these two signals. The differential distribution of eye-position sensitivity and sound-location sensitivity suggests that this process has begun by the level of the IC but is not yet complete at this stage. We discuss how these signals might fit into Groh and Sparks' vector subtraction model for coordinate transformations.