Academic radiology
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Targeted therapy can lead to considerable tumor reduction and may result initially in altered tissue at constant tumor size. In this setting, Response Evaluation Criteria in Solid Tumors (RECIST) can be inadequate for assessing early treatment response. Choi-criteria combine both size and density measurements. Our purpose was to evaluate computed tomography (CT) images of melanoma patients under BRAF-inhibitor therapy according to Choi-criteria which were adapted to our study (aChoi). ⋯ Our initial data indicate that aChoi-criteria can reflect response to vemurafenib earlier compared to RECIST. This is of clinical significance as BRAF-inhibitors are cost-intensive targeted therapies and can cause severe side effects, so criteria for early therapy response have to be evaluated.
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To determine if the rate of major discrepancies between resident preliminary reports and faculty final reports increases during the final hours of consecutive 12-hour overnight call shifts. ⋯ In a single academic medical center, major discrepancies in resident preliminary reports increased significantly during the final 2 hours of consecutive 12-hour overnight call shifts. This finding could be related to either fatigue or circadian desynchronization. Discrimination of these two potential etiologies requires additional investigation as major discrepancies in resident reports have the potential to negatively impact patient care/outcome. Cross-sectional imaging modalities including computed tomography and ultrasound (versus conventional radiography), as well as inpatient location (versus Emergency Department location), were also associated with significantly higher major discrepancy rates.
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A lecture series aimed at providing new radiology residents a rapid course on the fundamental concepts of professionalism, safety, and interpretation of diagnostic imaging was established. Evaluation of the course's educational value was attempted through surveys. ⋯ This collection of introductory lectures on professionalism, safety, and diagnostic imaging, delivered early in the first year of the radiology residency, requires a reasonable number of invested preparation hours by the faculty but results in a universal increase in resident confidence. However, we were unable to demonstrate an objective improvement in resident performance on clinical rotations.
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To evaluate the accuracy of a novel combined electromagnetic (EM) navigation/image fusion system for biopsy of small lesions. ⋯ A combined image-fusion/EM tracking platform can provide a high degree of needle placement accuracy (<5 mm) when targeting small lesions. Results fall within accuracy of respiratory error; with best results obtained by incorporating an EM sensor into the tip of the biopsy system.
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The aim of this study was to establish reference curves and formulas for aortic cross-sectional area in patients from infancy to young adulthood. ⋯ Measurement of aortic area was reproducible. The established reference curves and formulas and minimal area ratios were convenient for further clinical use.