German Radiologists Research Articles

Prevalence of burnout among German radiologists: a call to action

ObjectivesIn the presence of escalating global concerns regarding physician burnout, this study aims to analyze the prevalence and associated factors of burnout among radiologists in Germany.MethodsA comprehensive online survey, inclusive of 73 targeted questions including a German-modified version of the Maslach Burnout Inventory, was distributed among all members of the German Radiological Society and the German Interventional Radiological Society between May and August 2023. The survey encompassed aspects of employment, workload, well-being, and coping mechanisms. Data from 172 completed surveys were analyzed, with correlations explored via crosstabs and the Pearson-chi-square test.ResultsIn total, 76.7% of participating radiologists were identified to be burnt out. The prevalence was significantly associated with increased workload, reduced sleep quality, suboptimal working conditions, reduced job satisfaction, and the negative interplay between work, family life, and health. Median work satisfaction was described as “satisfied” while median workload was assessed as “frequently overwhelming of work.” A total of 41.9% of respondents noted facing daily time pressure. Radiologists’ concerns about work interfering with private family life were voiced by approximately 70%, and 73.3% highlighted the perceived negative effects on their health.ConclusionThe pronounced prevalence of burnout among German radiologists demonstrates an urgent, unmet need for comprehensive interventions and systemic changes. Our findings act as a catalyst for initiating targeted, multifaceted strategies and dialogs, essential for fostering a resilient and effective healthcare ecosystem. Further large-scale systematic studies should follow to analyze the findings in broad.Clinical relevance statementConsistent with other countries, there is a high prevalence of burnout among radiologists in Germany. A call for further investigation is recommended to help mitigate adverse outcomes associated with physician burnout.Key Points• The prevalence of burnout has yet not been evaluated for German radiologists.• German radiologists have a high prevalence of burnout.• Steps must be implemented to engage this problem to prevent worsening.Graphical abstract

German Radiological Society and the Professional Association of German Radiologists position paper on coronary computed tomography: clinical evidence and quality of patient care in chronic coronary syndrome

This position paper is ajoint statement of the German Radiological Society (DRG) and the Professional Association of German Radiologists (BDR), which reflects the current state of knowledge about coronary computed tomography (CT). It is based on preclinical and clinical studies that have investigated the clinical relevance as well as the technical requirements and fundamentals of cardiac computed tomography.

German Radiological Society and the Professional Association ofGerman Radiologists Position Paper on Coronary computed tomography: Clinical Evidence and Quality of Patient Care in Chronic Coronary Syndrome.

This position paper is a joint statement of the German Radiological Society (DRG) and the Professional Association of German Radiologists (BDR), which reflects the current state of knowledge about coronary computed tomography. It is based on preclinical and clinical studies that have investigated the clinical relevance as well as the technical requirements and fundamentals of cardiac computed tomography. CITATION FORMAT: · Langenbach MC, Sandstede J, Sieren M et al. DRG and BDR Position Paper on Coronary CT: Clinical Evidence and Quality of Patient Care in Chronic Coronary Syndrome. Fortschr Röntgenstr 2023; 195: 115 - 133.

Physicians\u2019 preferences and willingness to pay for artificial intelligence-based assistance tools: a discrete choice experiment among german radiologists

BackgroundArtificial Intelligence (AI)-based assistance tools have the potential to improve the quality of healthcare when adopted by providers. This work attempts to elicit preferences and willingness to pay for these tools among German radiologists. The goal was to generate insights for tool providers and policymakers regarding the development and funding of ideally designed and priced tools. Ultimately, healthcare systems can only benefit from quality enhancing AI when provider adoption is considered.MethodsSince there is no established market for AI-based assistance tools in radiology yet, a discrete choice experiment was conducted. Respondents from the two major German professional radiology associations chose between hypothetical tools composed of five attributes and a no-choice option. The attributes included: provider, application, quality impact, time savings and price. A conditional logit model was estimated identifying preferences for attribute levels, the no-choice option, and significant subject-related interaction effects.Results114 respondents were included for analysis of which 46% were already using an AI-based assistance tool. Average adoption probability for an AI-based tool was 81% (95% CI 77.1% − 84.4%). Radiologists preferred a tool that assists in routine diagnostics performing at above-radiologist-level quality and saves 50% in diagnostics time at a price-point of €3 per study. The provider is not a significant factor in the decisions. Time savings were considered more important than quality improvements (i.e., detecting more anomalies).ConclusionsRadiologists are overall willing to invest in AI-based assistance tools. Development, funding, and research regarding these tools should, however, consider providers’ preferences for features of immediate everyday and economic relevance like time savings to optimize adoption.

Musculoskeletal Radiology in Germany - A Status Quo from the German Roentgen Society (DRG) and the Association of German Radiologists (BDR)

Musculoskeletal Radiology in Germany - A Status Quo from the German Roentgen Society (DRG) and the Association of German Radiologists (BDR)

Metal objects of the head and neck region in magnetic resonance imaging : Survey among radiologists

Although in recent times more research has been done on interactions of metallic dental objects in magnetic resonance imaging (MRI), radiologists are often uncertain whether the objects should be removed or can be retained prior to an impending examination. On the one hand, they want to avoid unnecessary material removal which is associated with costs and potential damage of the dental object. On the other hand, they fear material-induced susceptibility artefacts will impair the diagnostic workup so that examinations will have to be repeated. The lack of information complicates adequate decision making for radiologists. The aim of this survey was to evaluate the information that is currently available to radiologists regarding orthodontic appliances of the head and neck region in the MRI and determine how to handle these situations in aradiologist's every day routine. Therefore, this study can reveal the need for further research. The questionnaire was published in the 9/2017 issue of the journal Der Radiologe and sent as an electronic version by the BDR (Professional Association of German Radiologists) to their approximately 1800 members. In addition, the radiological institutes of 55German university and maximum care clinics were contacted. In all, 74 evaluable responses were received within aperiod of 16weeks, representing aresponse rate of 3.7%. Altogether, the participants rate the risks of adetachment or heating of orthodontic appliances as too high. The interviewed radiologists categorize the available data as insufficient and they almost unanimously (97.3%) demand adeclaration requirement for the manufacturers. There is aclear need for further education (78.3%). Intraoral measurement of the magnetic permeability is considered as auseful tool to determine possible interactions with the MRI by 40.5%.

Creating high-quality radiology reports in foreign languages through multilingual structured reporting.

Globalization and migration are increasing the demand for reports in different languages. We aimed to examine if structured reports created by non-German-speaking radiologists with multilingual templates show significant differences in quality to structured reports and free-text reports by German native speakers. We used structured templates that allow radiologists to report in their mother tongue and then switch the report language to German or English automatically using proprietary software. German- and English-speaking radiology residents created structured reports in both German and English with these templates. Reports for three different exam types were created (intensive care chest x-ray, shoulder x-ray specifically for degenerative processes, and CT pulmonary angiogram for pulmonary embolism). The report quality of automatically translated German structured reports by English-speaking radiologists and German structured reports by German radiologists was then evaluated by German clinicians with a standardized questionnaire. The questionnaire was designed to assess attributes including content, comprehensibility, clinical consequences, and overall quality. Structured reports by English-speaking radiologists that were automatically translated into German and Germanstructured reports by German radiologists both received very high or high overall quality ratings in the majority of cases, showing no significant differences in quality. Likewise, no significant differences were observed between the two report types regarding comprehensibility and clinical consequences. Structured reports by German radiologists received significantly better ratings for overall quality and comprehensibility compared to free-text reports by German radiologists. Multilingual structured reporting templates may serve as a feasible tool for creating high-quality radiology reports in foreign languages. • Multilingualism in structured reporting templates can be a useful tool for creating high-quality radiology reports in foreign languages. • German reports created with multilingual structured reporting templates by English-speaking radiologists and German structured reports by German radiologists exhibit no significant differences in overall report quality. • Multilingual structured reporting templates can help radiologists overcome communication barriers and facilitate teleradiology.

A Review of Scientific Topics and Literature in Abdominal Radiology in Germany--Part 2: Abdominal Parenchymal Organs.

The working group for abdominal and gastrointestinal diagnosis is a group of the German Radiological Society (DRG) focusing clinically and scientifically on the diagnosis and treatment of the gastrointestinal tract as well as the parenchymal abdominal organs. In this article we give an up-to-date literature review of scientific radiological topics especially covered by German radiologists. The working group experts cover the most recent relevant studies concerning liver-specific contrast media with an emphasis on a new classification system for liver adenomas. Additionally studies regarding selective internal radiotherapy (SIRT) are reviewed. For the pancreas the most important tumors are described followed by an introduction to the most recently introduced functional imaging techniques. The manuscript concludes with some remarks on recent studies and concerning chronic pancreatitis as well as autoimmune pancreatitis. • Different subtypes of liver adenomas with different therapeutic consequences can be differentiated by MRI • Most recently published studies focus on liver imaging with extracellular liver specific contrast media as well as diffusion weighted imaging. They consider this new method having a high diagnostic potential. • For pancreatic neoplasm diagnosis diffusion--as well as perfusion--imaging is considered as a highly promising method.

A Review of Scientific Topics and Literature in Abdominal Radiology in Germany - Part 1: Gastrointestinal Tract.

The working group for abdominal and gastrointestinal diagnosis is a group of the German Radiological Society (DRG) focusing clinically and scientifically on the diagnosis and treatment of the gastrointestinal tract with all parenchymatous abdominal organs. In addition to the clinical and scientific further development of abdominal radiology, the education of radiologists within this core discipline of radiology is one of the major aims. In this article we give an up-to-date literature review of scientific radiological topics especially covered by German radiologists. This manuscript focuses on the most recent literature on the diagnosis of the stomach, small bowel, colon and rectum. The review with a focus on the most recent studies published by German radiologists concludes with a synopsis of mesenterial bleeding and ischemia followed by a critical appraisal of the current literature on conventional abdominal radiography. Based on recent literature and guidelines there is a change of paradigms regarding the diagnosis of esophagus and gastric cancer towards CT, which is considered equally to endosonography. For small bowel imaging in Crohn's disease ultrasound as well as MRI with a new focus on DWI are the most important imaging modalities scientifically. For colonic diagnosis virtual colonoscopy has replaced the conventional radiological methods. For staging of rectal carcinoma as well as for therapeutic stratification a high resolution MRI of the pelvis is of paramount interest. Multislice CT is considered the most important modality to assess mesenteric ischemia or bleeding.

Prevalence of latent tuberculosis infection in German radiologists

Healthcare workers have an increased risk of tuberculosis infection compared with the general population. There have been few attempts to quantify the prevalence of latent tuberculosis infection amongst German healthcare workers, due to inadequacy of the current tuberculin skin test (TST). Therefore, it was our aim to investigate the prevalence of latent tuberculosis in this cohort using a tuberculosis-specific ELISpot (T-SPOT.TB) test and to compare the performance of this test to that of the TST. Ninety-five healthy participants working in departments of radiology were examined by ELISpot, lymphocyte transformation test and TST. For cellular in-vitro tests, tuberculosis-specific peptides and purified protein derivate (PPD) were used as antigens. These tests were combined with a questionnaire on prior tuberculosis exposure. Out of 95 healthcare workers, only one (1%) was defined as positive by T-SPOT.TB, 92 (97%) by PPD-ELISpot, 78 (82%) by PPD-lymphocyte transformation test and 32 (34%) by TST. Multivariate analysis showed that the TST was significantly affected (P<0.0001 and P=0.001, respectively) by foreign birth and prior skin testing. The T-SPOT.TB test results were independent of foreign birth, prior skin testing and prior vaccination against tuberculosis. In contrast to the TST, T-SPOT.TB appears to be an accurate and useful tool to track tuberculosis infection in this at-risk group. With only one of 95 participants having acquired latent tuberculosis, these preliminary results argue for a low incidence of latent tuberculosis in German radiologists.

Wirtschaftliche Evaluation angiographischer Interventionen einschließlich einer radiologischen stationären und ambulanten Patientenbetreuung

To determine the economic efficiency of a whole-radiology in- and outpatient treatment with angiographic interventions performed as the main or sole therapy. The calculations represent the data of a university radiology department, including the following angiographic interventions (neuroradiology not considered): Vascular intervention (PTA, stent implantation) of kidneys and extremities, recanalization of hemodialysis access, chemoembolization, diagnostic arterioportal liver CT, port implantation, varicocele embolization, PTCD, percutaneous implantation of biliary stent. First, the different angiographic interventions are categorized with reference to the German DRG system 2005. Considering the example of a university hospital, the individual cost of each intervention is calculated and correlated with reimbursements by G-DRG2005 and so-called "ambulant operation" (EBM200plus). With these data, profits and losses are calculated for both in- and outpatient care. Radiologic interventions of inpatients yield a profit in the majority of cases. With a base rate of 2900 euros, the profits in our university hospital range between - 872 euros and + 3411 euros (mean: + 1348 euros). On the other hand, those angiographic interventions suitable for "ambulant operation" generate average profits of + 372 euros, if only direct costs are considered. The data of outpatient radiological interventions average between 381 euros up to 1612 euros lower than compared with profits obtained from in patient care. Once an angiographic intervention represents the major or sole therapy, German radiologists are advised to operate out- and inpatient care by themselves. In Germany, the G-DRG-system and EBM enable radiology departments to generate considerable proceeds for their hospitals and, secondly, to yield a valuable add-on profit for their own department budget, which then is partly detached from the inflexible conventional reimbursement of radiological services.

TME14/457: Teleradiology: Opinion and technical requirements of German radiologists

IntroductionFor the evolution and acceptance of solutions in telemedicine - concerning e. g. liability, economics, security, medical and technical quality - it is very important to learn what the opinion and concepts of the present and future users - the medical professionals - are.MethodsIn 1997 a questionnaire was sent to 4400 German radiologists in hospitals and private offices with a response rate of 5 %. Intensive statistical analysis has been performed by SAS. The survey has been funded by the German government represented by BMBF and DFN. To evaluate the changes in the opinion and technical requirements a second questionnaire was sent to 1500 radiologists in May 1999.ResultsThe results showed that in 1997 only 47 % of responders felt well informed about teleradiology. 83% of the radiologists use PC, 52% have installed workstations, 33% use the DICOM 3.0 Standard, PACS are installed in 14 % of the institutions. In the opinion of German radiologists its main future application areas will be the emergency and expert consultation, but - more and more - radiologist services were expected to be provided from home or central offices too. Image and report transfer plus common telemedicine integration as well as interfaces to reference databases, educational applications, technical quality surveillance and product support (maintenance) were considered to be increasingly important areas. Smaller institutions judged expert consultation as more important than bigger institutions. Technical standardization and system stability were strongly demanded. From the medico-legal point of view, there was a demand for as strong as possible an association between radiological report and image, appropriate data security, and solutions of liability questions as well as for guidelines, e. g. of correct documentation and necessary image quality. Links to RIS and PACS were considered especially important for those who already work with these systems. The introduction of fair payments was mainly a matter of the radiologists in private consulting rooms. Most of radiologists thought that lossy compression should be allowed if no loss of relevant information occurs.DiscussionTechnically most demands can be fulfilled today but are not yet commonly included in teleradiology or telemedicine systems. Other aspects as legal or financial requirements must be discussed and solutions provided before the majority will use telemedicine. It must be recognized that there exist many different application areas with different requirements. Local conditions and interests of radiologists - and other medical or non-medical groups - are different too.

Teleradiology: results of a questionnaire of German radiologists.

A questionnaire was sent by mail to 4400 radiologists (i.e. to at least 1000 radiological institutions). The response rate was about 5%. The results showed that 47% of respondents felt well informed about teleradiology, 49% not enough and 3% not at all. Image and report transfer as well as interfaces to reference databases, educational applications, technical quality surveillance and product support (maintenance) were considered to be increasingly important areas. Smaller institutions (1-3 doctors) judged expert consultation as more important than bigger institutions. Standardization, system stability and data security were demanded as well as guidelines, for example concerning the linking of report and image, correct documentation and required image quality. Technically most demands can be fulfilled today but this technology is not yet commonly included in teleradiology systems.

1897--celebrating the centennial--Hermann Moritz Gocht and radiation therapy in the treatment of trigeminal neuralgia.

Among German radiologists and orthopaedic surgeons Hermann Moritz Gocht (1869-1938) is one of the most prominent figures. In addition to his noteworthy contributions to the progress of orthopaedic surgery, in 1897 he introduced the use of radiotherapy for the treatment of trigeminal neuralgia. Subsequently the value of this technique was widely recognized by radiologists and neurosurgeons, and it is still acclaimed as the most brilliant intuition of this famous pioneer of radiology. Gocht made also important contributions to the technical development of X-ray apparatus and to the definition of the radiological anatomy of the skeleton, as well as to orthopaedic surgical pathology. The aim of this paper is to celebrate the centennial of Gocht's introduction of radiotherapy in the treatment of neuralgic syndromes and to express our appreciation of the work of this eminent scientist.

Chronic Gastric Ulcer on the Posterior Wall

CHRONIC ulcers that lie on the posterior gastric wall demonstrate some unique clinical and pathologic features that can be attributed to their anatomic location. This does not apply to craters that reach the lesser curve, although strangely, it includes those that extend to the greater curve. The clinician has observed that the chronic posterior wall ulcer is encountered mainly in older patients. Summarizing some large series recorded in the literature, one finds that about 65% of all chronic posterior wall lesions of the pars media are first recognized after age 50, as compared with only 35% of chronic anterior wall pars media ulcers. The figures for craters that lie within the antrum and within the fundus are difficult to interpret because of varying definitions of these anatomic regions. French and German radiologists and surgeons have emphasized on many occasions that more than the expected proportion of women is encountered among

A Note on Zinc Filters

SINCE Dr. Coutard's recent visit to this country, there has been considerable interest aroused among radiologists regarding the use of zinc as a filtering material in 200 peak kilovolt therapy. Coutard uses zinc for part of his work, as do many of the German radiologists. From theoretical considerations one would not expect to find any great difference in the relative efficiencies of the two metals as filters. However, it was deemed advisable to make actual measurements so that all doubt would be removed. An x-ray machine of the Villard circuit was employed, operating at approximately 200 peak kilovolts. The intensity measurements were made with a Victoreen r meter. Relative Intensities.—Figure 1 shows absorption curves for zinc and copper. It is evident from these curves that equal thicknesses of zinc and copper transmit approximately the same quantity of radiation.