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Jalloul M, Miranda-Schaeubinger M, Noor AM, Stein JM, Amiruddin R, Derbew HM, Mango VL, Akinola A, Hart K, Weygand J, Pollack E, Mohammed S, Scheel JR, Shell J, Dako F, Mhatre P, Kulinski L, Otero HJ, Mollura DJ. MRI scarcity in low- and middle-income countries. NMR IN BIOMEDICINE 2023; 36:e5022. [PMID: 37574441 DOI: 10.1002/nbm.5022] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 08/15/2023]
Abstract
Since the introduction of MRI as a sustainable diagnostic modality, global accessibility to its services has revealed a wide discrepancy between populations-leaving most of the population in LMICs without access to this important imaging modality. Several factors lead to the scarcity of MRI in LMICs; for example, inadequate infrastructure and the absence of a dedicated workforce are key factors in the scarcity observed. RAD-AID has contributed to the advancement of radiology globally by collaborating with our partners to make radiology more accessible for medically underserved communities. However, progress is slow and further investment is needed to ensure improved global access to MRI.
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Affiliation(s)
- Mohammad Jalloul
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Abass M Noor
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- RAD-AID International, Chevy Chase, Maryland, USA
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Joel M Stein
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Raisa Amiruddin
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hermon Miliard Derbew
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Victoria L Mango
- RAD-AID International, Chevy Chase, Maryland, USA
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Kelly Hart
- Tufts Medical Center, Boston, Massachusetts, USA
| | | | - Erica Pollack
- RAD-AID International, Chevy Chase, Maryland, USA
- University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
| | - Sharon Mohammed
- RAD-AID International, Chevy Chase, Maryland, USA
- Bellevue Hospital Center NYCHHC, New York, New York, USA
| | - John R Scheel
- RAD-AID International, Chevy Chase, Maryland, USA
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jessica Shell
- RAD-AID International, Chevy Chase, Maryland, USA
- Siemens Medical Solutions USA, Inc., Cary, North Carolina, USA
| | - Farouk Dako
- RAD-AID International, Chevy Chase, Maryland, USA
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Pradnya Mhatre
- RAD-AID International, Chevy Chase, Maryland, USA
- Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Hansel J Otero
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Schwartz FR, Clark DP, Rigiroli F, Kalisz K, Wildman-Tobriner B, Thomas S, Wilson J, Badea CT, Marin D. Evaluation of the impact of a novel denoising algorithm on image quality in dual-energy abdominal CT of obese patients. Eur Radiol 2023; 33:7056-7065. [PMID: 37083742 PMCID: PMC10902821 DOI: 10.1007/s00330-023-09644-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES Evaluate a novel algorithm for noise reduction in obese patients using dual-source dual-energy (DE) CT imaging. METHODS Seventy-nine patients with contrast-enhanced abdominal imaging (54 women; age: 58 ± 14 years; BMI: 39 ± 5 kg/m2, range: 35-62 kg/m2) from seven DECT (SOMATOM Flash or Force) were retrospectively included (01/2019-12/2020). Image domain data were reconstructed with the standard clinical algorithm (ADMIRE/SAFIRE 2), and denoised with a comparison (ME-NLM) and a test algorithm (rank-sparse kernel regression). Contrast-to-noise ratio (CNR) was calculated. Four blinded readers evaluated the same original and denoised images (0 (worst)-100 (best)) in randomized order for perceived image noise, quality, and their comfort making a diagnosis from a table of 80 options. Comparisons between algorithms were performed using paired t-tests and mixed-effects linear modeling. RESULTS Average CNR was 5.0 ± 1.9 (original), 31.1 ± 10.3 (comparison; p < 0.001), and 8.9 ± 2.9 (test; p < 0.001). Readers were in good to moderate agreement over perceived image noise (ICC: 0.83), image quality (ICC: 0.71), and diagnostic comfort (ICC: 0.6). Diagnostic accuracy was low across algorithms (accuracy: 66, 63, and 67% (original, comparison, test)). The noise received a mean score of 54, 84, and 66 (p < 0.05); image quality 59, 61, and 65; and the diagnostic comfort 63, 68, and 68, respectively. Quality and comfort scores were not statistically significantly different between algorithms. CONCLUSIONS The test algorithm produces quantitatively higher image quality than current standard and existing denoising algorithms in obese patients imaged with DECT and readers show a preference for it. CLINICAL RELEVANCE STATEMENT Accurate diagnosis on CT imaging of obese patients is challenging and denoising algorithms can increase the diagnostic comfort and quantitative image quality. This could lead to better clinical reads. KEY POINTS • Improving image quality in DECT imaging of obese patients is important for accurate and confident clinical reads, which may be aided by novel denoising algorithms using image domain data. • Accurate diagnosis on CT imaging of obese patients is especially challenging and denoising algorithms can increase quantitative and qualitative image quality. • Image domain algorithms can generalize well and can be implemented at other institutions.
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Affiliation(s)
- Fides R Schwartz
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA.
| | - Darin P Clark
- Quantitative Imaging and Analysis Lab, Department of Radiology, Duke University, Durham, NC, USA
| | - Francesca Rigiroli
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
| | - Kevin Kalisz
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
| | - Benjamin Wildman-Tobriner
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
| | - Sarah Thomas
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
| | | | - Cristian T Badea
- Quantitative Imaging and Analysis Lab, Department of Radiology, Duke University, Durham, NC, USA
| | - Daniele Marin
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
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Lynch T, Bockhold S, McNulty JP. Factors influencing the choice of radiology as a medical specialty in Ireland. Eur J Radiol 2022; 151:110297. [DOI: 10.1016/j.ejrad.2022.110297] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/22/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022]
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Abstract
Residents have a limited time to be trained. Although having a highly variable caseload should be beneficial for resident training, residents do not necessarily get a uniform distribution of cases. By developing a dashboard where residents and their attendings can track the procedures they have done and cases that they have seen, we hope to give residents a greater insight into their training and into where gaps in their training may be occurring. By taking advantage of modern advances in NLP techniques, we process medical records and generate statistics describing each resident's progress so far. We have built the system described and its life within the NYP ecosystem. By creating better tracking, we hope that caseloads can be shifted to better close any individual gaps in training. One of the educational pain points for radiology residency is the assignment of cases to match a well-balanced curriculum. By illuminating the historical cases of a resident, we can better assign future cases for a better educational experience.
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Affiliation(s)
- Hongyu Chen
- Weill Cornell Medical College, 1300 York Ave, New York, NY, 10065, USA
| | - Vineeth Gangaram
- Vagelos College of Physicians and Surgeons, 630 W 168th St, New York, NY, 10032, USA
| | - George Shih
- Weill Cornell Radiology, 1305 York Avenue, 3rd Floor, New York, NY, 10021, USA.
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Greyling AGW, Pitcher RD. Who PACS a Punch? The Role of the Picture Archiving and Communication System/Radiology Information System (PACS/RIS) in Quantifying Experiential Learning in Radiology Residency. J Digit Imaging 2018; 31:792-798. [PMID: 30030765 PMCID: PMC6261195 DOI: 10.1007/s10278-018-0106-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The clinical logbook is the currently accepted tool for evaluating experiential learning (EL) in postgraduate radiology training programs internationally. The role of the picture archiving and communication system/radiology information system (PACS/RIS) in defining the complete EL portfolio of radiology residents has not been explored. To conduct a PACS/RIS-based analysis of the comprehensive clinical outputs of radiology residents, and to correlate outputs with residency recruitment criteria and exit examination performance. Retrospective, customized searches of the institutional PACS/RIS were conducted to determine the clinical outputs of radiology residents completing a standardized 4-year training program at a single institution in a middle-income country. The association between outputs and prior-to-residency radiology experience, prior-to residency completion of the primary examination, and performance in the exit examination were determined. Fifteen residents were included. Average clinical output was 8286 cases, with a wide range (6268-10460). Total output was not associated with first-time exit examination success (p=0.16). Residents with prior radiology experience tended to greater success at first exit examination attempt (10/11, 91% versus 2/4, 50%; p=0.09), despite lower average outputs (8138 versus 8695). Outputs were not associated with prior completion of the radiology primary examination (8263 versus 8378; p=0.87). This first PACS/RIS-based analysis of the complete clinical outputs of any radiology residency training program provides important baseline educational data, with the potential to inform discourses on specialty training internationally. It demonstrates the potential for the modern PACS/RIS to supersede the traditional logbook and to serve as a comprehensive EL portfolio for radiology residents.
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Affiliation(s)
- Abraham Gerhardus Wilhelmus Greyling
- Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Richard Denys Pitcher
- Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
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Linaker KL, Arpin SA, Fischer CP, Sackett M, Georger L. Tumor imaging instruction and assessment at chiropractic colleges in North America: a pilot study with implications for National Board of Chiropractic Examiners content. THE JOURNAL OF CHIROPRACTIC EDUCATION 2017; 31:125-131. [PMID: 28742975 PMCID: PMC5656148 DOI: 10.7899/jce-16-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This pilot study tested a survey instrument pertaining to the instruction and assessment of tumor imaging in chiropractic training programs. The secondary purpose was to gather data regarding credentials of lead instructors, textbook and resource use, and tumors taught and assessed. METHODS An electronic survey was distributed to lead tumor imaging instructors at all chiropractic colleges in the United States and Canada. A focus group of tumor imaging instructors was conducted to clarify ambiguous data. RESULTS Diplomate status with the American Chiropractic Board of Radiology was held by 87.5% of the instructor respondents. There were similarities in course content and assessment across institutions. A total of 26 tumors were considered clinically significant by more than 65% of instructors, 9 tumors were identified as not clinically significant by more than 65%, and 4 tumors were considered clinically significant by 35% to 65% of instructors. There was correlation between those instructors who evaluated on various tumors and those who feel it is important to evaluate such tumors (rS = 0.94, p < .001). The focus group addressed the 4 equivocal tumors and recommended 3 be added to the list of clinically insignificant tumors. CONCLUSION The survey instrument is ready to be used to conduct a study of all clinical areas of the chiropractic curriculum. A total of 12 tumors were recommended for removal from National Board of Chiropractic Examiners tests. The authors recommend that the Academics Committee of the American Chiropractic Board of Radiology share information regarding learning libraries to allow for a richer learning experience across all campuses.
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Rehani B, Zhang YC, Rehani MM, Palkó A, Lau L, Lette MNM, Dillon WP. Radiology education in Europe: Analysis of results from 22 European countries. World J Radiol 2017; 9:55-62. [PMID: 28298965 PMCID: PMC5334502 DOI: 10.4329/wjr.v9.i2.55] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 09/17/2016] [Accepted: 12/02/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the state of radiology education across Europe by means of a survey study.
METHODS A comprehensive 23-item radiology survey was distributed via email to the International Society of Radiology members, national radiological societies, radiologists and medical physicists. Reminders to complete the survey were sent and the results were analyzed over a period of 4 mo (January-April 2016). Survey questions include length of medical school and residency training; availability of fellowship and subspecialty training; number of residency programs in each country; accreditation pathways; research training; and medical physics education. Descriptive statistics were used to analyze and summarize data.
RESULTS Radiology residency training ranges from 2-6 years with a median of 5 years, and follows 1 year of internship training in 55% (12 out of 22) European countries. Subspecialty fellowship training is offered in 55% (12 out of 22) European countries. Availability for specialization training by national societies is limited to eight countries. For nearly all respondents, less than fifty percent of radiologists travel abroad for specialization. Nine of 22 (41%) European countries have research requirements during residency. The types of certifying exam show variation where 64% (14 out of 22) European countries require both written and oral boards, 23% (5 out of 22) require oral examinations only, and 5% (1 out of 22) require written examinations only. A degree in medical physics is offered in 59% (13 out of 22) European countries and is predominantly taught by medical physicists. Nearly all respondents report that formal examinations in medical physics are required.
CONCLUSION Comparative learning experiences across the continent will help guide the development of comprehensive yet pragmatic infrastructures for radiology education and collaborations in radiology education worldwide.
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Rehani B, Brown I, Dandekar S, Sarkodie B, Mwango G, Rehani MM, Lau L, Zhang YC, Dillon WP. Radiology Education in Africa: Analysis of Results From 13 African Countries. J Am Coll Radiol 2017; 14:247-252. [PMID: 27818015 DOI: 10.1016/j.jacr.2016.08.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/08/2016] [Accepted: 08/15/2016] [Indexed: 11/26/2022]
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Msaouel P, Keramaris NC, Tasoulis A, Kolokythas D, Syrmos N, Pararas N, Thireos E, Lionis C. Burnout and training satisfaction of medical residents in Greece: will the European Work Time Directive make a difference? HUMAN RESOURCES FOR HEALTH 2010; 8:16. [PMID: 20594310 PMCID: PMC2909970 DOI: 10.1186/1478-4491-8-16] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2009] [Accepted: 07/01/2010] [Indexed: 05/29/2023]
Abstract
BACKGROUND The aim of this study is to determine the prevalence of burnout in Greek medical residents, investigate its relationship with training satisfaction during residency and survey Greek medical residents' opinion towards the European Work Time Directive (EWTD). METHODS A Multi-centre, cross-sectional survey of Greek residents was performed. The Maslach Burnout Inventory (MBI) was used to measure burnout, which was defined as high emotional exhaustion, combined with high depersonalization or low personal accomplishment. In addition, seven questions were designed for this study to evaluate self-reported resident training satisfaction and three questions queried residents' opinion on the EWTD and its effects on their personal and social life as well as their medical training. Univariate, bivariate and multivariate statistical models were used for the evaluation of data. RESULTS Out of 311 respondents (77.8% response rate), 154 (49.5%) met burnout criteria and 99 (31.8%) indicated burnout on all three subscale scores. The number of residents that were dissatisfied with the overall quality of their residency training were 113 individuals (36.3%). Only 32 residents (10.3%) believed that the EWTD implementation will not have any beneficial effects for them. CONCLUSIONS Both burnout and training dissatisfaction were common among Greek residents. Systemic interventions are thus required within the Greek health system, aimed at reducing resident impairment due to burnout and at improving their educational and professional perspectives. Although residents' opinion on the EWTD was not associated with burnout levels, the EWTD was found to be predominantly supported and anticipated by Greek residents and should be implemented to alleviate their workload and stress.
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Affiliation(s)
- Pavlos Msaouel
- Greek Junior Doctors and Health Scientists Society, Greece
| | | | | | | | | | | | - Eleftherios Thireos
- Athens Medical Society, Athens, Greece
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Greece
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