AJR. American journal of roentgenology
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Headache in children is a common symptom and often is worrisome for clinicians and parents because of the breadth of possible underlying significant abnormalities, including meningitis, brain neoplasms, and intracranial hemorrhage. For this reason, many children with headaches undergo neuroimaging. Most neuroimaging studies performed of children with headaches have normal findings but may lead to significant downstream effects, including unnecessary exposure to ionizing radiation or sedation, as well as unnecessary cost to the health care system. In this article, we review the current evidence and discuss the role of neuroimaging in the diagnosis and management of pediatric headaches, with a special focus on tools that may aid in increasing the rate of positive findings, such as classification systems, algorithms, and red flag criteria. ⋯ Many tools exist that can help in improving the appropriateness of neuroimaging in pediatric headache. The main issues that remain to be addressed include scientific proof of safety and validity of these tools and clarity regarding the risks, benefits, and cost-effectiveness of CT versus MRI in various clinical settings and scenarios.
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AJR Am J Roentgenol · Jan 2018
Making Time for Patients: Positive Impact of Direct Patient Reporting.
Using a novel patient-centric approach, we assessed the impact of direct patient radiology reporting on the patient experience and patient perception of radiologists in a high-volume head and neck clinic. ⋯ Direct patient reporting by the radiologist is feasible in a high-volume head and neck clinic and has a positive impact on the patient experience. Major factors that enabled direct patient reporting included our embedded reading room and the use of a standardized reporting template. After the consultation, more patients wanted to receive information from the radiologist and had a better understanding of the imaging results.
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AJR Am J Roentgenol · Jan 2018
American College of Radiology-Compliant Short Protocol Breast MRI for High-Risk Breast Cancer Screening: A Prospective Feasibility Study.
The purpose of this study was to assess the feasibility of a short protocol for screening breast MRI that is noninferior to standard-of-care (SOC) MRI in image quality that complies with American College of Radiology accreditation requirements. ⋯ Short-protocol breast MRI comprising a T2-weighted sequence and a fast dynamic sequence with less than 10-minute acquisition time is feasible and has image quality at least equivalent to that of an SOC MRI protocol with a > 20-minute mean acquisition time. Larger studies comparing the cancer detection rate, sensitivity, and specificity of each imaging protocol are needed to determine whether short-protocol breast MRI can replace SOC MRI to screen patients at high breast cancer risk.
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AJR Am J Roentgenol · Jan 2018
Predictability of 99mTc-Galactosyl Human Serum Albumin Scintigraphy for Posthepatectomy Liver Failure.
Posthepatectomy liver failure (PHLF) is one of the most serious complications after hepatectomy. The objective of the present study is to assess the potential diagnostic ability of 99mTc-galactosyl human serum albumin (GSA) scintigraphy to predict PHLF as defined by the International Study Group of Liver Surgery (ISGLS). ⋯ Technetium-99m-labeled GSA scintigraphy is useful for predicting PHLF, particularly for applying an accurate resection line on GSA-SPECT images.
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AJR Am J Roentgenol · Jan 2018
Gender Differences in the Publication Rate Among Breast Imaging Radiologists in the United States and Canada.
The purpose of this study is to determine whether academic achievement differs by gender among breast imaging radiologists. ⋯ The number of publications by female radiologists has risen steadily over time; however, a significant gender disparity is seen in scholarly productivity.