Radiology Meetings Research Articles

Survey of UK radiology trainees in the aftermath of 'Modernising Medical Careers'.

BackgroundFollowing implementation of Modernising Medical Careers (MMC) in the UK, potential radiology trainees must decide on their career and apply sooner than ever before. We aimed to determine whether current trainees were sufficiently informed to make an earlier career decision by comparing the early radiology experiences of Traditional and Foundation Trainees.Methods344 radiology trainees were appointed through MMC in 2007/08. This cohort was surveyed online.ResultsResponse rate was 174/344 (51%). Traditional Trainees made their career decision 2.6 years after graduation compared with 1.2 years for Foundation Trainees (57/167, 34%). Nearly half of responders (79/169, 47%) experienced no formal radiology teaching as undergraduates. Most trainees regularly attended radiology meetings, spent time in a radiology department and/or performed radiology research. Many trainees received no career advice specific to radiology (69/163, 42%) at any point prior to entering the specialty; this includes both formal and informal advice. Junior doctor experiences were more frequently cited as influencing career choice (98/164, 60%). An earlier career decision was associated with; undergraduate radiology projects (-0.72 years, p = 0.018), career advice (-0.63 years, p = 0.009) and regular attendance at radiology meetings (-0.65 years, p = 0.014).ConclusionEarly experience of radiology enables trainees to make an earlier career decision, however current radiology trainees were not always afforded relevant experiences prior to entering training. Radiologists need to be more proactive in encouraging the next generation of trainees.

Radiology teaching for future paediatricians

BackgroundImaging, an integral part of paediatric clinical practice, often requires a specialist opinion. Although traditionally this opinion comes from paediatric radiologists or radiologists with a special interest in paediatrics, paediatricians...

Clinical indications for musculoskeletal ultrasound: A Delphi-based consensus paper of the European society of musculoskeletal radiology

To develop clinical guidelines for musculoskeletal ultrasound (MSKUS) referral in Europe. Sixteen musculoskeletal radiologists from seven European countries participated in a consensus-based interactive process (Delphi method) using consecutive questionnaires and consensus procedure meetings at several European radiology meetings. The evaluation of musculoskeletal diseases was established by literature reviews, followed by consensus on clinical utility in three consensus meetings. This involved a thorough, transparent, iterative approach which including interview, questionnaire, Delphi and standard setting methodologies. European MSK radiologists with a special interest in MSKUS formed two different expert groups who worked on reaching a consensus in the first two meetings. The third meeting resolved questions that did not achieve a consensus level of 67% using the first two questionnaires. On expert consensus, the use of MSKUS is indicated to detect joint synovitis, fluid and septic effusion for potential aspiration, and poorly indicated to detect loose bodies. Recommendations for most appropriate use of musculoskeletal ultrasound are reported in six areas relevant to musculoskeletal ultrasound: hand/wrist, elbow, shoulder, hip, knee and ankle/foot. A comprehensive evidence-based, expert consensus-defined educational framework on clinical ultrsound is presented. This should facilitate referrals for this important imaging technique throughout Europe. Musculoskeletal ultrasound is indicated for detecting joint synovitis, effusions and fluid collections. • Musculoskeletal ultrasound is poor at detecting loose bodies. • Musculoskeletal ultrasound is relevant for most joints.

The role of morbidity and mortality meetings in interventional radiology

PurposeTo understand the current practice of interventional radiology (IR) morbidity and mortality (M&M) meetings among interventional radiologists in Europe, and to develop a set of results-based recommendations to increase the prevalence of IR M&M meetings. Materials and methodsOnline electronic surveys were sent to members of the Cardiovascular and Interventional Radiology Society of Europe (CIRSE). Each survey consisted of 18 questions pertaining to IR M&M meetings. ResultsA total of 150 CIRSE members responded to the survey. Approximately 47% of respondents held IR M&M meetings in their departments. Among those who held IR M&M meetings, 42% held them monthly and 68% rated the quality of the meetings as good or excellent. Of those who did not have M&M meetings, 94% were interested in incorporating M&M meetings into their future practice. The most common reasons for not holding IR M&M meetings were lack of time (68%) and small IR practice groups (43%). A total of 85% were interested in learning more about IR M&M meetings. The preferred method of education about M&M meetings included annual radiology meetings (44%), peer-reviewed articles in radiology journals (31%), websites (26%), and newsletters (15%). ConclusionsThe data demonstrate that although current practice of M&M meetings in European IR departments is limited, the majority of respondents believe that M&M meetings are beneficial to their practice. There is a need for guidelines or standards of practice to incorporate such meetings in IR departments to prevent medical errors, which may ultimately lead to enhanced patient safety and outcomes.

A Review of the Clinical Evidence for Intensity-modulated Radiotherapy

Aims Intensity-modulated radiotherapy (IMRT) is a development of three-dimensional conformal radiotherapy that offers improvements in dosimetry in many clinical scenarios. Here we review the clinical evidence for IMRT and present ongoing or unpublished randomised controlled trials (RCTs). Methods We identified randomised and non-randomised comparative studies of IMRT and conventional radiotherapy using MEDLINE, hand-searching Radiotherapy and Oncology and the International Journal of Radiation Oncology, Biology and Physics and the proceedings of the American Society for Therapeutic Radiology and Oncology and the European Society for Therapeutic Radiology and Oncology annual meetings. The metaRegister of Controlled Trials was searched to identify completed-unpublished, ongoing and planned RCTs. Results Sixty-one studies comparing IMRT and conventional radiotherapy were identified. These included three RCTs in head and neck cancer (205 patients) and three in breast cancer (664 patients) that had reported clinical outcomes; these were all powered for toxicity-related end points, which were significantly better with IMRT in each trial. There were 27 additional non-randomised studies in head and neck (1119 patients), 26 in prostate cancer (>5000 patients), four in breast cancer (875 patients) and nine in other tumour sites. The results of these studies supported those of the RCTs with benefits reported in acute and late toxicity, health-related quality of life and tumour control end points. Twenty-eight completed-unpublished, ongoing or planned RCTs incorporating IMRT were identified, including at least 12,310 patients, of which 15 compared conventional radiotherapy within IMRT as a randomisation or pre-planned stratification. Discussion Inverse-planned IMRT maintains parotid saliva production and reduces acute and late xerostomia during radiotherapy for locally advanced head and neck cancer, reduces late rectal toxicity in prostate cancer patients allowing safe dose escalation and seems to reduce toxicity in several other tumour sites. Forward-planned IMRT reduces acute toxicity and improves late clinician-assessed cosmesis compared with conventional tangential breast radiotherapy.

Sodium bicarbonate for the prevention of contrast-induced nephropathy: a meta-analysis of 17 randomized trials

Contrast-induced nephropathy (CIN) is a common cause of acute kidney injury. Several preventive therapies for this injury have been tested; however, there is still no consensus on the optimal protocol. We performed a systematic search of the National Library of Medicine and the Cochrane Library databases from January 1985 to November 2008 to identify randomized controlled studies examining sodium bicarbonate as a preventive measure for CIN in humans. We also reviewed conference abstracts from cardiology nephrology and radiology meetings from 2004 to 2008. A change in serum creatinine levels defined by an absolute (>or=0.5 mg/dl) or percentage (>or=25%) increase in the serum creatinine level is defined as CIN. The primary outcome measure was the incidence of CIN, and the secondary outcome measures were: change in serum creatinine from baseline, requirement for renal replacement therapy and death. Seventeen randomized controlled trials have investigated the role of sodium bicarbonate for prophylaxis of CIN. The overall incidence of CIN was 11.3%. Using the results from all 17 studies that compared bicarbonate versus saline, the pooled relative risk of developing CIN was 0.54 (95% CI, 0.36-0.83) in the intervention arm, indicating a significant benefit from sodium bicarbonate. The pooled relative risk of CIN was 0.57 (95% CI, 0.35-0.95) when we analyzed for the studies that compared the effects sodium bicarbonate to NAC on development of CIN. There was no difference in the rates of requirement for renal replacement therapy and death. The use of sodium bicarbonate appears to reduce the incidence of CIN when compared to other preventive strategies for CIN without a significant difference in the requirement of renal replacement therapy and mortality. There are study heterogeneity and publication biases. Further adequately powered randomized controlled studies are needed to determine whether sodium bicarbonate will reduce the clinically meaningful outcomes (e.g., need for dialysis or death) and optimal hydration strategy in high-risk patients.

Medico‐legal radiology ‐ Edited by WSC Hare

By WSC Hare. Published by Churchill Livingston, Elsevier Publishers, Sydney, 2007. 200 pages. A$79.00. ISBN 978 072 953 8312. It is an honour to review this book which contains some of the distilled wisdom of a radiological giant. Professor William SC Hare was the first Australian Professor in Radiology and held the Chair in Melbourne from 1965 to 1988. His career was remarkable both in innovation and scope of practice. Between 1990 and 2000 he provided legal opinion on the radiological aspects of hundreds of cases. Radiologists in training would do well to follow Professor Hare’s advice in separate chapters on interpreting diagnostic images and writing reports. Much of this book contains ‘must knows’ for one’s career in radiology. In the crowded curriculum, it is all too easy for the trainee to be mesmerized by exotica most of us seldom encounter. Professor Hare shines the spotlight on the common pitfalls of our specialty. Radiologists at all stages in their career would benefit from the 10 chapters devoted to different parts of the body. These chapters have a compelling style considerably enhanced with many succinct pertinent examples of actual litigation. A useful summary list of ‘suggestions’ is given at the end of each of the 15 chapters. The literature up to the end of 2006 has been most thoroughly reviewed and scores of key references selected. This book is particularly timely as radiologists enter an era of individual recertification. Different countries will introduce processes that vary in detail. However, common to all will be a paradigm shift in culture of scrutiny of our personal performance. Those who read this book and follow its advice will provide a better service for patients and clinicians, as well as reduce their own vulnerability to claims of professional malpractice or misconduct. Radiological error and discrepancy is a most sensitive topic. Professor Hare’s balanced analysis will prove very helpful for clinical directors and conveners of radiological discrepancy meetings. Readers will gain very useful advice on how to word radiological reports that are likely to be used in deciding legal outcomes (e.g. compensation cases). There are several chapters on legal processes, including sections on the radiologist as a defendant and another on the radiologist as a witness. I anticipate that this book will also prove very popular with orthopaedic surgeons and other clinicians who provide medico-legal reports, as well as with lawyers involved in personal injury and medical litigation work. This is a book all radiologists should own and read. It is the product of unrivalled experience, scholarship, wisdom and an awesome amount of research. There are now two beacons in the medico-legal radiological firmament: Leonard Berlin and William Hare.

First Author Research Productivity of United States Radiation Oncology Residents: 2002–2007

Participation in investigative research is a required element of radiation oncology residency in the United States. Our purpose was to quantify the first author research productivity of recent U.S. radiation oncology residents during their residency training. We performed a computer-based search of PubMed and a manual review of the proceedings of the annual meetings of the American Society for Therapeutic Radiology and Oncology to identify all publications and presented abstracts with a radiation oncology resident as the first author between 2002 and 2007. Of 1,098 residents trained at 81 programs, 50% published > or =1 article (range, 0-9), and 53% presented > or =1 abstract (range, 0-3) at an American Society for Therapeutic Radiology and Oncology annual meeting. The national average was 1.01 articles published and 1.09 abstracts presented per resident during 4 years of training. Of 678 articles published, 82% represented original research and 18% were review articles. Residents contributed 15% of all abstracts at American Society for Therapeutic Radiology and Oncology annual meetings, and the resident contribution to orally presented abstracts increased from 12% to 21% during the study period. Individuals training at programs with >6 residents produced roughly twice as many articles and abstracts. Holman Research Pathway residents produced double the national average of articles and abstracts. Although variability exists among individuals and among training programs, U.S. radiation oncology residents routinely participate in investigative research suitable for publication or presentation at a scientific meeting. These data provide national research benchmarks that can assist current and future radiation oncology residents and training programs in their self-assessment and research planning.

ACR International Outreach Activities

International outreach is a factor that is increasingly shaping the practice of medicine including radiology. More research and development work is being done outside the United States than in years past, and other countries are investing more in their health care delivery systems. As these investments are made, radiologists and others naturally turn to the United States to learn what we are doing. Conversely, we are becoming more interested in their clinical and research contributions. More and more international colleagues are attending radiology meetings in the United States, and more Americans are registering for meetings abroad.

Recording and Reenactment of Collaborative Diagnosis Sessions using DICOM

This paper presents a radiological collaborative tool capable of direct manipulation of Digital Imaging and Communications in Medicine (DICOM) images on both sides, and also recording and reenacting of a recorded session. A special collaborative application protocol formerly developed was extended and used as basis for the development of collaborative session recording and playback processes. The protocol is used today for real-time radiological meetings through the Internet. This new standard for collaborative sessions makes possible other uses for the protocol, such as asynchronous collaborative sessions, decision regulation, auditing, and educational applications. Experimental results are given which compare this protocol with other popular collaborative approaches. Comparison of these results shows that the proposed protocol performs much better than other approaches when run under controlled conditions.

Publication Rates for Abstracts Presented by Korean Investigators at Major Radiology Meetings

ObjectiveTo determine the publication rate of abstracts presented by Korean investigators at national and international radiological meetings, and to identify predictive factors of publication.Materials and Methodss presented at the annual meetings of the Korean Radiological Society (KRS), and abstracts presented by Korean investigators at the annual meetings of the Radiological Society of North America (RSNA) and European Congress of Radiology (ECR) from 2001 to 2002 were searched for subsequent publication, using PubMed and the Korean Medical Database. The following variables were evaluated. 1) The overall publication rate; 2) the publication rates according to the radiological subspecialty, presentation type (oral or poster), sample size (≤ 20, 21-50, or > 50), study design (prospective or retrospective), statistical analysis (present or absent), and study outcome (positive or negative); 3) the time to publication; 4) the journal where the study was published; 5) consistency between the abstract and the final publication.ResultsOf 1,097 abstracts, 301 (27.4%) were subsequently published, at an average of 15.8 ± 13.8 months after presentation in 48 journals. The publication rates for studies presented at the RSNA (35.4%) and ECR (50.5%) conferences were significantly higher than that for the KRS conference (23.6%, p < 0.05). Vascular/interventional radiology studies had the highest publication rate (33.1%), whereas musculoskeletal radiology studies had the lowest publication rate (17.1%). Other factors associated with subsequent publication were prospective design, use of statistical testing, and a positive study outcome.ConclusionThe publication rate is significantly lower for the KRS (23.6%) meeting abstracts as compared to those of the RSNA (35.4%) and ECR (50.5%). Prospective design, use of statistical testing, and positive study outcome have a statistically significant effect on the publication rate.

Scientific Presentations at Radiologic Meetings, Subsequent Full-Text Publications, and Authors' Country of Origin

Scientific Presentations at Radiologic Meetings, Subsequent Full-Text Publications, and Authors' Country of Origin

Simple Method for Inserting Flash Movies into PowerPoint Presentations

This article describes a simple method for inserting Shockwave Flash (Adobe) movies into PowerPoint (Microsoft) slides. Shockwave Flash is the latest recommended file format for presenting dynamic data sets in PowerPoint at radiologic society meetings. Unfortunately, the standard method recommended by Microsoft for inserting Flash into PowerPoint is cumbersome and labor intensive. The procedure also can be intimidating for many radiologists. This article offers a solution that entails a simple PowerPoint macro.

Robert Reid Newell

For several decades starting in the 1920s, speakers at national radiology meetings were accustomed to a tall, balding man sitting in the front row and peering intently at them. Pinned to his jacket was a plastic device with wires leading to his ears. The device was an early hearing aid. The intent peering was lip reading, and the man was Robert Reid Newell, for 45 years a radiologist at Stanford University. He had been deaf since childhood, but he had not let that impediment prevent him from attaining the status of a world leader in radiology.

Using Macromedia Flash for Electronic Presentations: A New Alternative

This article provides a step-by-step tutorial for creating electronic presentations using Macromedia Shockwave Flash, one of the recommended file formats for many radiologic society annual meetings, including the American Roentgen Ray Society (ARRS). Although Flash and PowerPoint can be used for creating presentation slide shows, Flash is more appropriate for integrating and delivering animations for Internet applications such as radiologic electronic presentations. For this reason, detailed step-by-step instructions for creating Flash slide shows with common features such as text, images, arrows, buttons, movie loops, and transitions are provided. The approach used in this article is particularly appropriate for academic radiologists who have basic PowerPoint skills but lack programming experience.

Congratulations to the winners, whose contributions help to maintain the high standard of the journal

It takes about 6 weeks for my Editor’s Comment to appear in print, so I apologise if I am writing in anticipation of events which, to many people reading this, might have become a distant memory. We have just recovered from an excellent EAU meeting in Paris, and are now getting ready to embark on the journey to Atlanta for the AUA. The rate at which these meetings are growing is testament to the popularity among urologists of going to a particular location not only to hear people talk about urology, but also to have the opportunity to meet friends and professional colleagues from all over the world. I very much enjoy these meetings for the reasons stated above; perhaps the suggestion that they will be replaced by distance-learning and other web-mediated events might not be quite so correct after all, at least at present. Many urologists worry that the meetings are becoming too large, and while this might have an element of truth about it, the relatively huge oncology, cardiology and radiology meetings do not seem to have suffered greatly. The BJU International presents one of its major prizes at the AUA every year. The Bob Krane prize is given to the person who wrote the best paper in the journal for the previous year. The winner is decided by the Associate Editors and the Editor-in-Chief. Each is asked for a list of the five best papers to appear, and then a short list of two is chosen and noted upon. The winner this year is Alun Thomas, a urologist from the UK, who wrote two outstanding papers which appeared together in the December issue of the journal. They described the long-term follow-up of untreated patients with urodynamically confirmed outlet obstruction and underactive detrusor seen, and followed up carefully, in the department of Paul Abrams in Bristol. I feel that such longitudinal natural history studies are very important for our understanding of how, in this case, the lower urinary tract works. The John Blandy prize will be presented at the BAUS meeting at the end of June. It is given to a urologist in training for the best publication in the previous year. It is obviously aimed at a different target from the Bob Krane prize, and this year it will be presented by Professor John Blandy himself to Nathan Lawrentschuk, from Melbourne, who published five excellent papers in the journal in 2005. Congratulations to the winners, whose contributions help to maintain the required high standard of publications in the journal.

Scientific papers presented at the 2000–2001 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) meetings: publication rates during the period 2000–2004

The aim of this study was to investigate the rate at which abstracts orally presented at the ESGAR 2000 and 2001 meetings were published between 2000-2004, and to identify predictive factors of publication. The abstracts of ESGAR meeting presentations were reviewed and classified according to organ, modality, type of design, country of origin of the studies and basic categories of diagnostic or interventional. The presentations were searched for publication in Medline-indexed journals using the PubMed server. The publication rates of the presentations, the time period between the presentation and publication, and the journal in which the article had appeared were investigated. An overall number of 109 publications were found originating from 276 presentations (39.5%). The median and inter-quartile range [IQR] between the abstract presentation and subsequently full publication was 18 months [1.0 -53.0]. The journal with the highest number of derived articles from abstract presentation was European Radiology (n=21, 19.2%). Retrospective studies were found to be more frequently published than prospective studies (p=0.001). The publication rate did not show any statistically significant difference between groups of other classifications. The publication rate of studies orally presented at ESGAR meetings was 39.5%. No specific variable other than the type of design of the studies appeared to influence the publication rate.

Publication of Material Presented at Radiologic Meetings: Authors' Country and International Collaboration

To estimate the influence of the authors' country and collaboration on the probability of subsequent full publication of material from oral presentations at the 2000 European Congress of Radiology (ECR). After searching the Medline database for articles published between 2000 and 2003, all articles that originated from presentations at the ECR in 2000 and were published in journals indexed in the Journal Citation Report were evaluated. Relative likelihood of full publication depending on the country in which an abstract originated was compared with that of Austria, which is the host country of the ECR. The chi(2) test was used to compare publication rates according to country of origin and collaboration. The median and interquartile range of the impact factor of publications according to country of origin and collaboration in the abstract were analyzed by using the Kruskal-Wallis test. The percentage of articles published in journals ranked in the top quartile (top 25% of journals according to impact factor) was calculated. Of 1020 presentations, 403 articles (39%) with significant (P < .001) variations according to country of origin were identified. Studies originating from the United States had the highest percentage of full publication (62%; relative likelihood, 1.41), median impact factor (4.5), and percentage of articles in the top quartile (54%). Radiology was the top quartile journal, with the most articles published (60%). Impact factor differed according to country of origin (P < .001). Abstracts submitted with collaboration between (a) European countries and countries outside of Europe (other than the United States) and (b) different European countries had the highest publication rates (83% and 52%, respectively; P = .03). The country of origin of an abstract was useful in predicting the chances of full publication of the abstract, with the United States having the highest publication rate. Authors were more likely to publish an article if it had been prepared with international collaboration.

Focal nodular hyperplasia in oncology patients

Sir, A case of multiple focal nodular hyperplasia (FNH) in a patient treated for stage III neuroblastoma was presented at the Midwest Society for Pediatric Radiology Meeting in September 2005 at Madison, Wisconsin. The patient received carboplatin, cyclophosphamide, Adriamycin, vincristine, cisplatin, and etoposide chemotherapy, right paraspinal thoracic irradiation, and stem cell bone marrow transplantation. Two years after initiation of retinoic acid therapy and 3 years after the diagnosis of neuroblastoma, numerous hepatic lesions (hyperdense on portal venous phase and isodense on delayed phase) were noted on surveillance CT imaging. Several new lesions were found on a short-term follow-up CT examination. This case complements the article by Joyner et al. [1] in Pediatric Radiology and allows some additional points: (1) other drugs may be implicated in the development of FNH, (2) chemotherapy-induced FNH may not necessarily be a late complication, and (3) knowledge of this complication may not necessarily obviate the need for biopsy. While many of the drugs used to treat this patient are associated with the development of FNH, retinoic acid should also be considered. The chemotherapeutic effect of retinoic acid is related to its promotion of cytodifferentiation and apoptosis. However, retinoic acid also has prothrombotic effects by inducing endothelial coupling of coagulation factors. Retinoic acid has been implicated in various thrombotic events including myocardial infarction, pulmonary embolism, venous thrombosis and stroke [2]. The time to development of FNH noted by Bouyn et al. [3] is 8.5 years for cytoreductive chemotherapy and 12.3 years for other chemotherapy. One of three cases presented by Joyner et al. occurred 3 years after diagnosis. The case presented here also occurred 3 years after diagnosis. While development of FNH is typically late, lesions can occur early and could be confused with metastatic disease. FNH can have many imaging appearances, and there is overlap with hepatic adenoma, hypervascular metastasis, and other hepatic malignancies [4]. While the diagnosis of FNH was suggested in the current patient, the lack of a central scar and the number of lesions resulted in a shortterm follow-up examination. The increase in the number of lesions on the follow-up examination was unsettling and resulted in confirmation of the diagnosis with biopsy. In conclusion, retinoic acid may be another drug implicated in development of FNH, chemotherapy-induced FNH may occur early, and biopsy may be necessary to confirm the diagnosis in atypical cases.

A Visit to the European Congress of Radiology Meeting

A Visit to the European Congress of Radiology MeetingEric J. Stern, Audio Available | Share