Specialty Of Radiology Research Articles

The impact of radiologists’ characteristics on the detection of COVID-19 in chest CT scans

PurposeTo retrospectively assess the relationships between radiologists’ characteristics and their performance in interpreting chest CTs for COVID-19 detection. MethodsUsing DetectedX software, performance data were collected online from 74 radiologists from 29 countries, who each interpreted 30 anonymized digital chest CTs (15 positive and 15 negative scans for COVID-19). Radiologist-specific information was also collected: radiology experience, radiological specialty, number of lung CTs read weekly, familiarity with and education about COVID-19 presentation, and suspected COVID-19 cases seen weekly. The influence of this radiologist-specific information on the radiologists’ sensitivity, specificity, and ROC AUC was determined using regression analysis. ResultsRadiologists without respiratory imaging specialization had greater ROC AUCs (0.83 vs. 0.70, p = .006) and sensitivities (74.0% vs. 47.7%, p = .002) than their specialized peers. Radiologists without COVID-19 case encounters had greater sensitivity (80.6% vs. 63.1%, p = .017) but lower specificity (71.1% vs. 83.4%, p = .014) than those who encountered at least one case weekly. ConclusionSpecialization and prior experience with COVID-19 may impact the interpretation of suspected COVID-19 chest CTs. Clinical significanceThese results show the importance of diverse expertise and continuous training in managing novel diseases like COVID-19. Incorporating varied perspectives and experiences could enhance diagnostic accuracy and ensure a more comprehensive approach to disease management. In the case of novel diseases, specialization may not provide the same advantage as with more familiar disorders. The diagnostic value of specific experience with a novel disorder may help to compensate for a lack of specialization in the field, particularly in emergent situations. While specialization is important, generalization also holds value and utility in appropriate contexts.

From Photography to Radiology: How Physicians Leveraged Early Hospital X-ray Machines to Supplant Photographers.

At the end of the nineteenth century, the advent of x-ray machines fueled American medicine's reliance on technology, transforming hospitals and the medical profession. X-ray manufacturers pursued the nascent hospital market as competition and patent feuds accelerated x-ray machine modifications. Hospitals incorporated clunky new machines and employed x-ray photographers, but as the unruly apparatus stabilized, physicians joining the new specialty of radiology discounted the toils of machine troubleshooting and promoted their medically qualified x-ray interpretations. This article frames early medical radiography in terms of boundary work, highlighting how discourse among physicians, x-ray photographers, and hospital administrators vied to establish a privileged demarcation between radiological science and photographic craft. Ultimately, radiologists supplanted x-ray photographers by leveraging the automation of x-ray machines and capitalizing on the epistemic shift from photographic objectivity to qualified interpretations. By focusing on this overlooked aspect of x-ray incorporation into hospitals, this work provides a unique perspective on how harnessing mechanization and authoritative medical interpretations can shift professional boundaries.

Long-term quality improvement in radiology specialty training at a tertiary cardiothoracic centre

ObjectivesThis quality improvement project (QIP) aimed to foster radiology training at a regional tertiary cardiothoracic centre that had very low trainee satisfaction rankings. MethodsTo study the problem and intervene timely, multiple methods were applied, including a local feedback survey, placement reorganisation, consultant encouragement to train as accredited supervisors, followed by departmental education portal creation and start of externally funded Visiting Fellowships and salaried Clinical Fellowships. The regional rating was monitored. The local feedback survey was distributed and analysed using descriptive statistics. Alongside the QIP, service expansion occurred. ResultsThe site regionally ranked 9/19 in 2 years. Local survey responses (53) showed continuous improvement; cardiothoracic subspecialty interest (+39%) and audit/academic involvement (+36%) increased. Multiple Fellowships were completed; internationally reputable placements were agreed upon. Most consultants trained as supervisors. Per increased demand, compulsory deanery posts were changed to motivation-based, and an additional salaried position was offered. Five fellows stayed in the region as subspecialist consultants. Unexpected challenges included space and workstation loss with service expansion, lack of regional surveys since 2019, and the global pandemic. Regardless, the results were positive with subspecialty interest and projected reputational effect increase. Local long-term survey provided sustainable data in detecting improvement areas. ConclusionsGiven the national radiologist shortage, this quality improvement project shows a possible positive impact of similar interventions, including workforce retention/recruitment and thus improving patient care. Advances in knowledgeContinuous feedback and quality improvement maintenance are valuable to enhance training quality locally and beyond.

Diagnostic accuracy of vision-language models on Japanese diagnostic radiology, nuclear medicine, and interventional radiology specialty board examinations.

The performance of vision-language models (VLMs) with image interpretation capabilities, such as GPT-4 omni (GPT-4o), GPT-4 vision (GPT-4V), and Claude-3, has not been compared and remains unexplored in specialized radiological fields, including nuclear medicine and interventional radiology. This study aimed to evaluate and compare the diagnostic accuracy of various VLMs, including GPT-4 + GPT-4V, GPT-4o, Claude-3 Sonnet, and Claude-3 Opus, using Japanese diagnostic radiology, nuclear medicine, and interventional radiology (JDR, JNM, and JIR, respectively) board certification tests. In total, 383 questions from the JDR test (358 images), 300 from the JNM test (92 images), and 322 from the JIR test (96 images) from 2019 to 2023 were consecutively collected. The accuracy rates of the GPT-4 + GPT-4V, GPT-4o, Claude-3 Sonnet, and Claude-3 Opus were calculated for all questions or questions with images. The accuracy rates of the VLMs were compared using McNemar's test. GPT-4o demonstrated the highest accuracy rates across all evaluations with the JDR (all questions, 49%; questions with images, 48%), JNM (all questions, 64%; questions with images, 59%), and JIR tests (all questions, 43%; questions with images, 34%), followed by Claude-3 Opus with the JDR (all questions, 40%; questions with images, 38%), JNM (all questions, 42%; questions with images, 43%), and JIR tests (all questions, 40%; questions with images, 30%). For all questions, McNemar's test showed that GPT-4o significantly outperformed the other VLMs (all P < 0.007), except for Claude-3 Opus in the JIR test. For questions with images, GPT-4o outperformed the other VLMs in the JDR and JNM tests (all P < 0.001), except Claude-3 Opus in the JNM test. The GPT-4o had the highest success rates for questions with images and all questions from the JDR, JNM, and JIR board certification tests.

Assessing interventional radiology specialty knowledge and perception amongst Tanzanian medical students before and after exposure to an immersive curriculum

This study aims to assess the impact that delivering an introductory interventional radiology (IR) lecture series has on the knowledge and perception of the specialty among medical students in a resource-limited setting with, until recently, no IR presence. An introductory four-hour lecture series in IR was delivered to third-year medical students in Tanzania. Prior to and following the lecture series, participants completed a 27-item paper-based survey assessing their knowledge and perception of the specialty. Out of a class of 213, the pre- and post-lecture survey was returned by 148 (69.5%) and 151 (70.9%) respondents, respectively. 94.5% of respondents indicated that they were aware of IR as a specialty. Among respondents, 97.3% expressed interest in having IR lectures integrated into their curriculum, compared to 29.0% that reported having any prior IR training. 27.3% believed their knowledge in IR compared to other specialties was either "good" or "excellent", which improved to 43.3% (p<0.001). Identification that IR physicians consult patients directly, have outpatient clinics, have inpatient beds, and do rounds improved from 55.4% to 81.1% (p<0.001), 49.7% to 60.3% (p=0.066), 48.3% to 66.7% (p=0.001), and 52.0% to 66.2% (p=0.013), respectively. By introducing short lectures on IR-relevant topics, knowledge and perception of IR improved among Tanzanian medical students. Early education and exposure to IR should be prioritized to promote the continued growth of the specialty in this setting.

Artificial intelligence advances in cardiovascular imaging

The medical specialty of radiology has experienced several extremely important and influential technical developments in the past that have affected how medical imaging is deployed. Artificial Intelligence (AI) is potentially another such development that will introduce fundamental changes to the practice of radiology. Among the most promising clinical applications of AI is diagnostic imaging, and mounting attention is being directed at establishing and fine-tuning its performance to facilitate the detection and quantification of a wide array of clinical conditions. Case studies of computer-aided diagnosis have shown excellent accuracy and specificity for detecting small radiographic abnormalities with the potential to improve public health.

Generative pretrained transformer-4, an artificial intelligence text predictive model, has a high capability for passing novel written radiology exam questions.

AI-image interpretation, through convolutional neural networks, shows increasing capability within radiology. These models have achieved impressive performance in specific tasks within controlled settings, but possess inherent limitations, such as the inability to consider clinical context. We assess the ability of large language models (LLMs) within the context of radiology specialty exams to determine whether they can evaluate relevant clinical information. A database of questions was created with official sample, author written, and textbook questions based on the Royal College of Radiology (United Kingdom) FRCR 2A and American Board of Radiology (ABR) Certifying examinations. The questions were input into the Generative Pretrained Transformer (GPT) versions 3 and 4, with prompting to answer the questions. One thousand seventy-two questions were evaluated by GPT-3 and GPT-4. 495 (46.2%) were for the FRCR 2A and 577 (53.8%) were for the ABR exam. There were 890 single best answers (SBA), and 182 true/false questions. GPT-4 was correct in 629/890 (70.7%) SBA and 151/182 (83.0%) true/false questions. There was no degradation on author written questions. GPT-4 performed significantly better than GPT-3 which selected the correct answer in 282/890 (31.7%) SBA and 111/182 (61.0%) true/false questions. Performance of GPT-4 was similar across both examinations for all categories of question. The newest generation of LLMs, GPT-4, demonstrates high capability in answering radiology exam questions. It shows marked improvement from GPT-3, suggesting further improvements in accuracy are possible. Further research is needed to explore the clinical applicability of these AI models in real-world settings.

BRIDGING THE GAP: UNDERSTANDING MEDICAL STUDENTS' AND INTERNS'PERCEPTIONS OF RADIOLOGY AS A CAREER CHOICE AT TAIF UNIVERSITY, SAUDI ARABIA

Background: Radiology is a fundamental pillar of modern medicine, providing essential diagnostic and treatment guidance. Despite its importance, radiology faces challenges in attracting medical students as a career option. Objective: To identify factors influencing medical students' and interns' perceptions of radiology as a specialty. Methods: A cross-sectional study was conducted among Taif University medical 6th-year medical students and interns using a self-administered questionnaire including items to explore participants' knowledge, perceptions, and interest in radiology as a potential career path. Results: The study included 216 students and interns with a response rate of 91.9%. Males constituted 79.2% of them. Only a minority (18.5%) considered radiology as their future career aspiration. Exposure to radiology lectures during medical school was the most appealing factor (37%). Significant deterrents included concerns about losing clinical skills (45.8%), occupational hazards (41.2%), lack of recognition (40.7%), and limited patient contact (39.8%). The absence of patient interactions was the primary reason for disinterest in radiology (29.2%).Males were more likely than female students to choose radiology as a future career (20.5% vs. 11.1%), p&lt;0.001. Also, participants with a higher level of knowledge about the radiology specialty were more likely than those with limited or no knowledge about it (33.3% vs. 25.2 and 7.7%, respectively), p=0.002. Conclusion:More than half of the medical students and interns surveyed expressed doubts about pursuing radiology. Male participants were more likely than female participants to be interested in radiology.To address this, introducing early and comprehensive diagnostic imaging education throughout the undergraduate years and incorporating theoretical and practical approaches could attract more medical students and interns to the field of radiology.

FDA-Approved Artificial Intelligence and Machine Learning (AI/ML)-Enabled Medical Devices: An Updated Landscape

As artificial intelligence (AI) has been highly advancing in the last decade, machine learning (ML)-enabled medical devices are increasingly used in healthcare. In this study, we collected publicly available information on AI/ML-enabled medical devices approved by the FDA in the United States, as of the latest update on 19 October 2023. We performed comprehensive analysis of a total of 691 FDA-approved artificial intelligence and machine learning (AI/ML)-enabled medical devices and offer an in-depth analysis of clearance pathways, approval timeline, regulation type, medical specialty, decision type, recall history, etc. We found a significant surge in approvals since 2018, with clear dominance of the radiology specialty in the application of machine learning tools, attributed to the abundant data from routine clinical data. The study also reveals a reliance on the 510(k)-clearance pathway, emphasizing its basis on substantial equivalence and often bypassing the need for new clinical trials. Also, it notes an underrepresentation of pediatric-focused devices and trials, suggesting an opportunity for expansion in this demographic. Moreover, the geographical limitation of clinical trials, primarily within the United States, points to a need for more globally inclusive trials to encompass diverse patient demographics. This analysis not only maps the current landscape of AI/ML-enabled medical devices but also pinpoints trends, potential gaps, and areas for future exploration, clinical trial practices, and regulatory approaches. In conclusion, our analysis sheds light on the current state of FDA-approved AI/ML-enabled medical devices and prevailing trends, contributing to a wider comprehension.

Summary of the 2022 ACR Intersociety Meeting

The ACR Intersociety Committee meeting of 2022 (ISC-2022) was convened around the theme of “Recovering From The Great Resignation, Moral Injury and Other Stressors: Rebuilding Radiology for a Robust Future.” Representatives from 29 radiology organizations, including all radiology subspecialties, radiation oncology, and medical physics, as well as academic and private practice radiologists, met for 3 days in early August in Park City, Utah, to search for solutions to the most pressing problems facing the specialty of radiology in 2022. Of these, the mismatch between the clinical workload and the available radiologist workforce was foremost—as many other identifiable problems flowed downstream from this, including high job turnover, lack of time for teaching and research, radiologist burnout, and moral injury.

Dying Undiagnosed: Challenges of Management of Ovarian Tumours in a Resource-Poor Setting in North-western Nigeria.

Ovarian cancer is the second most prevalent but most lethal gynaecologic malignancy in our institution. This study aimed at determining the rate of non-diagnosis in suspected lesions and reviewing the management challenges of ovarian tumours highly suspicious for malignancy in our hospital. A three-year retrospective review of patients' records from the ward, clinic, theatre, and histopathology laboratory was carried out. Cases with high indices of suspicion for ovarian cancer (ovarian tumour with malignant radiologic features with any of ascites, pleural effusion, as well as cachexia, anaemia, or evidence of metastasis) were included. In-depth interviews were carried out with a consultant from each specialty of Radiology, Radio-oncology, Pathology, and Gynaecologic oncology at the gynaecologic oncology multidisciplinary team meeting. One hundred and twenty-two cases of highly suspicious ovarian malignancies were seen with a mean age of 40.6 years. Of these, 28 (23%) had surgery and 77% did not have any form of histological diagnosis. Of those that had surgery, 13 (46.4%) had upfront surgery and 15 (53.6%) neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Only two cases had documented complete (R0) debulking. Among those that had upfront surgery, one case (7.7%) was an ovarian fibroid and one (7.7%) was a fibrosarcoma while two cases (15.4%) were borderline ovarian tumours. Chemotherapy was commenced based on malignant cells on ascitic or pleural fluid cytology in three cases. Of all the malignant cases, epithelial carcinomas were commonest accounting for 48%. Aside from the general late presentation of cases, insufficient funds for treatment, poor coverage of health insurance for cancer care, unavailability of routine immunohistochemistry, lack of germline and somatic testing, non-availability or prohibitive cost of some chemotherapeutic agents, unavailability of maintenance therapies, inadequate capacity to manage toxicities, inadequate skill across all specialties, unavailability / erratic function of computerized tomography scans and unavailable positron emission tomography, lack of interventional radiology facility amongst others were all identified as challenges to management. Most patients with tumours highly suspicious for ovarian cancers did not get a histologic diagnosis and probably died undiagnosed. Management of ovarian cancer remains a challenge despite advances in surgical and chemotherapeutic options. Health insurance for all, infrastructure development, and training of all disciplines involved is recommended.

Improving Equitable Access to Imaging: Developing an On-Site Ultrasound Service at a Student-Run Free Clinic

Background: Student-run free clinics (SRFC) provide comprehensive primary care for uninsured populations throughout the country. However, imaging remains a barrier to care for underserved communities that experience inequitable access to healthcare. In this study, we describe the establishment of a radiology specialty clinic (RSC) that served as an in-house ultrasound imaging service at our institution's SRFC.&#x0D; Methods: Between September 2019 and March 2020, patients were scheduled for imaging at the free clinic site, and studies were performed and read by institutional radiologists. Patient data were reviewed to assess patient demographics, study indication, ultrasound type, and time between referral and appointment. Lastly, imaging utilization was examined seven months prior to and seven months after implementing the free ultrasound clinic to assess any changes in usage, wait time, or referral patterns using Fischer’s exact test and unpaired student t-tests.&#x0D; Results: A total of 10 patients were seen during the clinic’s operation, with 11 studies being performed. Overall, usage patterns stayed consistent pre and post-implementation. There was no significant difference in wait times between referral and appointment (pre-RSC 15 days vs. post-RSC 18.5 days, p=0.91) and the RSC demonstrated a total cost savings of $770 to the clinic.&#x0D; Conclusions: We describe the implementation of an in-house ultrasound imaging service at our SRFC. The RSC provided increased access to imaging, demonstrated cost-savings to the SRFC, and had no negative effects on ultrasound usage or wait times between referrals and appointments.

Core Entrustable Professional Activities for Entering Residency: A National Survey of Graduating Medical Students' Self-Assessed Skills by Specialty.

The Association of American Medical Colleges described 13 Core Entrustable Professional Activities (EPAs) that graduating students should be prepared to perform under indirect supervision on day one of residency. Surgery program directors recently recommended entrustability in these Core EPAs for incoming surgery interns. We sought to determine if graduating students intending to enter surgery agreed they had the skills to perform these Core EPAs. Using de-identified, individual-level data collected from and about 2019 Association of American Medical Colleges Graduation Questionnaire respondents, latent profile analysis was used to group respondents based on their self-assessed Core EPAs skills' response patterns. Associations between intended specialty, among other variables, and latent profile analysis group were assessed using independent sample t -tests and chi-square tests and multivariable logistic regression methods. Among 12,308 Graduation Questionnaire respondents, latent profile analysis identified 2 respondent groups: 7,863 (63.9%) in a high skill acquisition agreement (SAA) group and 4,445 (36.1%) in a moderate SAA group. Specialty was associated with SAA group membership (p < 0.001), with general surgery, orthopaedic surgery, and emergency medicine respondents (among others) overrepresented in the high SAA group. In the multivariable logistic regression models, each of anesthesiology, ophthalmology, pediatrics, psychiatry, and radiology (vs general surgery) specialty intention was associated with a lower odds of high SAA group membership. Graduating students' self-assessed Core EPAs skills were higher for those intending general surgery than for those intending some other specialties. Our findings can inform collaborative efforts to ensure graduates' acquisition of the skills expected of them at the start of residency.

Medical workforce in the United States.

This section focuses on the professional workforce comprised of the primary medical specialties that utilize ionizing radiation in their practices. Those discussed include the specialties of radiology and radiation oncology, as well as the subspecialties of radiology, namely diagnostic radiology, interventional radiology, nuclear radiology, and nuclear medicine. These professionals provide essential health care services, for example, the interpretation of imaging studies, the provision of interventional procedures, radionuclide therapeutic treatments, and radiation therapy. In addition, they may be called on to function as part of a radiologic emergency response team to care for potentially exposed persons following radiation events, for example, detonation of a nuclear weapon, nuclear power plant accidents, and transportation incidents. For these reasons, maintenance of an adequate workforce in each of these professions is essential to meeting the nation's future needs. Currently, there is a shortage for all physicians in the medical radiology workforce.

Healthy Work Environments: An Interprofessional Partnership Model to Promote Positive Workplace Culture

Background: Healthy work environments (HWEs) are a primary focus of leaders in health care. Many nurse- specific HWE initiatives exist to improve workplace culture; however, workplace harm persists. An interprofessional partnership model is needed to sustain healthy workplace cultures to promote engagement among providers and employees, and safe, high-quality patient care. Methods: The 5-Stage Process® is a method for teams to openly examine workplace behavior, co-creating their future using continuous quality improvement strategies of Team Building, Assessment, Implementation, Evaluation, and Sustainability. To ensure success, each stage should be completed with focused attention to the concrete strategies the team needs to take to sustain the healthy work environment. Results: The entire 5-Stage Process® was used by interprofessional teams from the specialties of Perinatology and Radiology at major health care institutions in the Midwest and Perioperative in the Northeast United States. Each team implemented one-on-one conflict resolution techniques, and one team noted improvements in employee engagement scores from 60% to 86%, patient satisfaction from 74% to 85%, safety perception scores from 70% to 79%, and teamwork perception scores from 82% to 84%. Conclusion: The interprofessional partnership 5-Stage Process® may be a successful method to continuously improve workplace cultures and ultimately improve patient safety and provider and staff satisfaction. Sustaining healthy work environments requires leaders’ constant focus and dedication to partnership techniques to ensure that new healthy behaviors persist.

Canadian Radiology Gender Pay Gap-Reality or Myth?

Introduction: Prior studies on Canadian physicians' income have demonstrated a gender pay gap (GPG); however, there is a paucity of data in the Radiology specialty. A cross-sectional study was conducted to determine if practicing Canadian radiologists' self-reported income is related to gender, controlling for demographic and work variables. Methods: English and French online surveys were distributed by email and social media to radiologists and trainees (May-July 2021). The association between Gender (controlling for Ethnicity variables, Region, having Children, Full-/Part-Time work, and Academic position) and Self-Reported Income was examined using chi-square tests. Pearson correlations examined relationships between opinion variables. Analyses were conducted using SPSS V28.0. A priori significance was P < .05. Study had ethics approval. Results: Four hundred and fifty-four practicing Canadian radiologists responded. Majority were women (51.2%, n = 227), a non-visible Minority (71.7%, n = 317), and from Western Provinces (67.8%, n = 308). Significant relationship was established between Self-Reported Income and Gender (χ2 = 10.44, df = 2, P < .05). More men (70.6%, n = 120) than women (56.4%, n = 110), reported income "greater than $500000"; fewer men (20.6%, n = 35) than women (35.9%, n = 70) reported "$300000-$500000"; a similar percent of men (8.8%, n = 15) and women (7.7%, n = 15) reported "less than $300000." No relationship was found between self-reported income and gender for ethnicity variables, those without children, part-time, or non-academic radiologists. The opinion "Addressing the GPG is important" correlated to "Canadian Association of Radiologists should collect demographic data" (r = 0.63). Responses were low for ethnic minorities and non-western provinces. Conclusion: Our results suggest a GPG exists in Canadian radiology and is an important first step for future studies.

A Review of Transsplenic Access for Portal Vein Interventions

Transsplenic portography was one of the first procedures performed in the developing specialty of interventional radiology. The technique was first described by Abeatici and Campi in 1951.[1] The procedure continued with various techniques until a standardized approach to these procedures was developed by Kreel in 1970 to increase the safety of the procedure and consistency of results.[2] Transsplenic portography had a relatively high rate of complications but was an important diagnostic tool until computed tomography (CT) rendered the procedure obsolete for diagnostic purposes.[3] Portography from this approach allowed the characterization of portal anatomy, direct measurement of portal pressure, characterization of varices, treatment of variceal bleeding, evaluation of infections, and diagnosis of hepatic tumors. The general procedure involved blind insertion of a 19-gauge needle into the 9th to 10th intercostal space with a slightly upward and posterior trajectory. The trajectory was adjusted until blood dripping from the needle indicated intravascular placement. A splenic pressure measurement was then taken (normal: 8–14 mm Hg from a transsplenic 19-gauge needle). 50 mL of 50% contrast was then injected and imaging was performed with cut-film. At the end of the procedure, the needle was removed without any maneuvers to aid hemostasis (as these embolic techniques were relatively unknown at that time). There was significant bleeding risk with these early procedures, and as such, the procedure was largely abandoned in the late 1970s with the wide adoption of abdominal CT. It was not until the early 2000s that renewed interest in transsplenic access led to series entering the literature with a new focus on therapeutic interventions from a splenic vein approach. Of note, these procedures had a significantly lower complication rate compared with the early studies in part owing to the ability to use advanced hemostatic maneuvers. Since 2009, there have been several small studies demonstrating safe and effective transsplenic interventions. In a series of 46 patients who underwent endovascular portal vein interventions via a transsplenic approach, technical success was achieved in 44 procedures, major bleeding complicated 3 procedures, and 6 patients experienced minor bleeding.[4] In a series of 22 pediatric patients who underwent successful transsplenic procedures, there was 1 major bleed and 1 minor bleed.[5] In another series on pediatric patients, 12 of 44 had significant bleeding.[3] In a series of 11 adults in which transsplenic access was performed to allow portal venous reconstruction (PVR) with transjugular intrahepatic portosystemic shunt (TIPS) placement in chronically thrombosed portal veins, 11 of 11 had TIPS placed successfully with no bleeding complications.[6] The available series are small but do give useful data on method of access and hemostasis given the variability in outcomes. In the series with the highest bleeding complications, 12 of 44 (27%), gel foam alone was used for tract embolization.[3] In Habib's TIPS-PVR series in which coils were utilized, there were no bleeding complications.[6]

Self-reported anatomy skills among Norwegian physicians - Need for improved postgraduate teaching provision

Anatomy skills are considered essential in all aspects of medical practice, and more so now than before with increasing use of diagnostic imaging techniques and advanced surgery. In conjunction with the revision of the medical study curriculum at the University of Oslo in 2014, we investigated Norwegian physicians’ assessment of their own anatomy knowledge and the educational provision of anatomical skills during and after specialization. A total of 902 Norwegian physicians divided into the specialties of general medicine, internal medicine, surgery, neurology and radiology responded to an anonymous survey. As many as 73% of the physicians had at some time point experienced insufficient anatomy knowledge in their own practice, most commonly among surgeons and neurologists. The respondents expressed a need for supplementary educational provision in anatomy during and after specialization, and 36% were unfamiliar with such offers. Notably, dissection courses seemed unavailable during specialization. Our findings demonstrate a requirement for an improved supply of anatomy education during and after specialization. Anatomy courses that combine dissection, radiological images and clinical application would seem desirable.

The 'Sic Vos non Vobis' of Interventional Radiology - Rebranding and modernising the Interventional Specialities of Radiology in Australia and New Zealand.

The 'Sic Vos non Vobis' of Interventional Radiology - Rebranding and modernising the Interventional Specialities of Radiology in Australia and New Zealand.

Elevate value in neck ultrasonography to a next level

We thank the authors for submitting their letter showing interest in our article “Radiologist-patient consultation of imaging findings after neck ultrasonography”.1 Thanks to technological advances, proven value in countless settings, and increased availability of medical imaging to healthcare providers, the specialty of radiology has moved to the center of clinical medicine. Not surprisingly, the number of medical imaging procedures has increased considerably over the years,2 and this also applies to the complexity of many individual imaging examinations.