Objective To explore the diagnostic efficacy of American Thyroid Association(ATA)guidelines,American College of Radiology Thyroid Imaging Report and Data System(ACR-TIRADS),and Chinese Thyroid Imaging Reporting and Data System(C-TIRADS)alone and combined with BRAF^V600E mutation in atypia of undetermined significance/follicular lesion of undetermined significance(AUS/FLUS).Methods A total of 138 patients who underwent ultrasound-guided fine needle aspiration(FNA)in the Chinese PLA General Hospital from January 2020 to May 2023 were selected.The clinicopathological and ultrasound characteristics were retrospectively analyzed for each nodule.Each nodule underwent preoperative BRAF^V600E mutation testing and was diagnosed according to the ATA guidelines,ACR-TIRADS,and C-TIRADS.The diagnostic efficacy of ATA guidelines,ACR-TIRADS,and C-TIRADS alone and combined with BRAF^V600E mutation was assessed based on the results of histopathological diagnosis.Results The 138 AUS/FLUS thyroid nodules included 45(32.6%)benign ones and 93(67.4%)malignant ones.The patient age(t=1.444,P=0.151),gender(χ²=0.259,P=0.611),and location of nodules(χ²=2.055,P=0.358)had no statistical significance for the differentiation between benign and malignant nodules,while nodule size(Z=2.500,P=0.012),echo(χ²=14.693,P<0.001),composition(χ²=17.075,P<0.001),aspect ratio ≥1(χ²=9.477,P=0.002),and microcalcification(χ²=6.892,P=0.009)were of significance for the differentiation.When applied alone,BRAF^V600E mutation showed high specificity(95.56%)and positive predictive value(95.65%).Among the three ultrasound grading systems,ACR-TIRADS had the highest sensitivity(χ²=37.923,P<0.001;χ²=40.462,P<0.001)and accuracy(χ²=81.595,P<0.001;χ²=76.912,P<0.001),while C-TIRADS had the highest specificity(χ²=11.746,P<0.001;χ²=21.235,P<0.001).However,the three systems showed no statistically significant difference in the diagnostic efficiency when applied alone(Z=1.177,P=0.239;Z=0.213,P=0.831;Z=1.016,P=0.310).The combination of BRAF^V600E mutation with ACR-TIRADS or C-TIRADS improved the diagnostic efficacy of BRAF^V600E mutation in distinguishing the benign and malignant AUS/FLUS nodules(Z=2.107,P=0.035;Z=2.752,P=0.006).The combination of ATA guidelines with BRAF^V600E mutation increased the diagnostic accuracy of BRAF^V600E mutation(χ²=20.679,P<0.001),while it had no statistically significant difference in distinguishing the benign and malignant AUS/FLUS nodules(Z=1.321,P=0.186).The combination of ATA guidelines,ACR-TIRADS,or C-TIRADS with BRAF^V600E mutation improved the diagnostic efficacy of ultrasound grading systems for AUS/FLUS nodules(Z=2.770,P=0.006;Z=2.770,P=0.006;Z=2.890,P=0.004).Specifically,ACR-TIRADS combined with BRAF^V600E mutation showed the highest sensitivity(χ²=4.712,P=0.030;χ²=4.712,P=0.030),while C-TIRADS combined with BRAF^V600E mutation showed the highest accuracy(χ²=77.627,P<0.001;χ²=85.827,P<0.001).However,there were no statistically significant differences in diagnostic performance between the combinations(Z=1.276,P=0.202;Z=0.808,P=0.419;Z=1.615,P=0.106).Conclusion ATA guidelines,ACR-TIRADS,and C-TIRADS combined with BRAF^V600E mutation can improve the diagnostic efficacy of BRAF^V600E mutation or ultrasound grading system alone in AUS/FLUS nodules,which can facilitate the further management and treatment of such patients.
Humans ; United States ; Infant ; Thyroid Neoplasms/genetics* ; Proto-Oncogene Proteins B-raf/genetics* ; Adenocarcinoma, Follicular/pathology* ; Retrospective Studies ; Data Systems ; Thyroid Nodule/genetics* ; Ultrasonography/methods* ; Mutation ; China ; Radiology

During interventional procedures,subjects are exposed to direct and scattered X-rays.Establishing diagnostic reference levels is an ideal way to optimize the radiation dose and reduce radiation hazard.In recent years,diagnostic reference levels in interventional radiology have been established in different countries.However,because of the too many indicators for characterizing the radiation dose,the indicators used to establish diagnostic reference levels vary in different countries.The research achievements in this field remain to be reviewed.We carried out a retrospective analysis of the definition,establishment method,application,and main factors influencing the dose difference of the diagnostic reference level,aiming to provide a basis for establishing the diagnostic reference level for interventional procedures in China.
Humans ; Diagnostic Reference Levels ; Radiology, Interventional/methods* ; Radiation Dosage ; Retrospective Studies ; Radiography

China ; Data Systems ; Humans ; Radiology ; Retrospective Studies ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Nodule ; Ultrasonography/methods* ; United States

Objective: To investigate the individual external dose level of some interventional radiology staffs from 2016 to 2020 in Tianjin City. Methods: All 2068 interventional radiology staffs who were included in the work of the Radiation Monitoring Project from 2016 to 2020 were selected as study subjects in March 2021. The individual dose monitoring results of interventional radiology staffs of different ages, working years, time and medical institutions were analyzed. Results: Among 2068 interventional radiology workers, 1406 (67.99%) were male and 662 (32.01%) were female. The age was 44.6 (39.2, 50.3) years, and the working years was 10.5 (4.3, 14.6) years. The annual effective doses per capita of 40-49 age group and ≥50 age group were higher than that of 30-39 age group (P<0.05) . The annual effective dose per capita of 5-9 working years was higher than that of <5 working years, and the annual effective dose per capita of 10-29 working years was higher than that of 5-9 working years (P<0.05) . The median per capita annual effective dose of the interventional radiology staffs was 0.164 mSv. There were 1976 interventional radiology staffs with an annual effective dose of <0.50 mSv/a (95.6%) . The collective dose distribution ration SR(0.5) was 41.1%. The difference of effective dose per capita in each year was statistically significant (H=19.23, P<0.05) . The per capita annual effective dose of interventional radiology staffs in tertiary medical institutions was higher than that in secondary medical institutions, and the difference was statistically significant (P<0.05) . Conclusion: The personal dose of interventional radiology staffs in Tianjin City is at a low level. It is necessary to emphasize the radiation hazard protection of interventional radiology staffs in tertiary medical institutions, 40-49 years old, ≥50 years old age groups and 5-9, 10-29 working years groups.
Adult ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure/prevention & control* ; Radiation Dosage ; Radiation Monitoring/methods* ; Radiation Protection ; Radiology, Interventional

Betacoronavirus ; Coronavirus Infections ; diagnosis ; epidemiology ; Diagnostic Imaging ; methods ; Humans ; Pandemics ; Pneumonia, Viral ; diagnosis ; epidemiology ; Radiology Department, Hospital ; organization & administration

Academic Medical Centers ; COVID-19/prevention & control* ; Cross Infection/prevention & control* ; Disinfection ; Hospitals, Isolation ; Humans ; Infection Control/methods* ; Infectious Disease Transmission, Patient-to-Professional/prevention & control* ; Radiology ; Radiology Department, Hospital/organization & administration* ; SARS-CoV-2 ; Singapore

Radiology is a unique medical specialty that focuses on image interpretation and report generation with limited patient contact. Resident read-out sessions with teaching are a quintessential part of reporting workflow practices in teaching institutions. However, most radiologist-educators do not have formal training in teaching and learning experiences vary. The five-step 'microskills' model ('one-minute preceptor' technique) developed by Neher is an easily adopted teaching model that complements the workflow of the typical read-out session, and can be utilised by radiologists of varied teaching experience and seniority. The steps are: (a) get a commitment; (b) probe for supporting evidence; (c) teach general rules; (d) reinforce what was done right; and (e) correct mistakes. Feedback is important to the model and accounts for two out of five microskills. The teaching model emphasises knowledge application and establishing relevance, which is useful in engaging the millennial resident. It is easily assimilated and applied by radiologist-educators.
Curriculum ; Education, Medical ; methods ; Humans ; Internship and Residency ; Learning ; Physicians ; Preceptorship ; Radiographic Image Interpretation, Computer-Assisted ; Radiography ; Radiology ; education ; trends ; Teaching

Radiology (imaging) and imaging-guided interventions, which provide multi-parametric morphologic and functional information, are playing an increasingly significant role in precision medicine. Radiologists are trained to understand the imaging phenotypes, transcribe those observations (phenotypes) to correlate with underlying diseases and to characterize the images. However, in order to understand and characterize the molecular phenotype (to obtain genomic information) of solid heterogeneous tumours, the advanced sequencing of those tissues using biopsy is required. Thus, radiologists image the tissues from various views and angles in order to have the complete image phenotypes, thereby acquiring a huge amount of data. Deriving meaningful details from all these radiological data becomes challenging and raises the big data issues. Therefore, interest in the application of radiomics has been growing in recent years as it has the potential to provide significant interpretive and predictive information for decision support. Radiomics is a combination of conventional computer-aided diagnosis, deep learning methods, and human skills, and thus can be used for quantitative characterization of tumour phenotypes. This paper discusses the overview of radiomics workflow, the results of various radiomics-based studies conducted using various radiological images such as computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET), the challenges we are facing, and the potential contribution of radiomics towards precision medicine.
Biomarkers, Tumor ; Diagnosis, Computer-Assisted ; Genome ; Genomics ; Humans ; Magnetic Resonance Imaging ; Neoplasms/therapy* ; Phenotype ; Positron-Emission Tomography ; Precision Medicine/methods* ; Radiology/methods* ; Radiology, Interventional/methods* ; Tomography, X-Ray Computed ; Workflow

Abdomen ; diagnostic imaging ; Attitude of Health Personnel ; Checklist ; Documentation ; methods ; Humans ; Liver ; diagnostic imaging ; Physicians ; Radiologists ; Radiology ; Referral and Consultation ; Surveys and Questionnaires ; Tomography, X-Ray Computed ; Ultrasonography

INTRODUCTIONThis study aimed to assess the ability of contrast-enhanced computed tomography (CECT) to detect active abdominopelvic haemorrhage in patients with blunt trauma, as compared to digital subtraction angiography (DSA).

METHODSIn this retrospective study, patients who underwent DSA within 24 hours following CECT for blunt abdominal and/or pelvic trauma were identified. The computed tomography (CT) trauma protocol consisted of a portal venous phase scan without CT angiography; delayed phase study was performed if appropriate. All selected CECT studies were independently reviewed for the presence of active extravasation of contrast by two radiologists, who were blinded to the DSA results. Fisher's exact test was used to correlate the presence of extravasation on CT with subsequent confirmed haemorrhage on DSA.

RESULTSDuring the eight-year study period, 51 patients underwent CECT prior to emergent DSA for abdominal or pelvic trauma. Evidence of active extravasation of contrast on CECT was observed in 35 patients and active haemorrhage was confirmed on DSA in 31 of these patients; embolisation was performed in all 31 patients. Two patients who were negative for active extravasation of contrast on CECT but positive for active haemorrhage on DSA had extensive bilateral pelvic fractures and haematomas. The sensitivity, specificity, and positive and negative predictive values of CECT in detecting active abdominopelvic haemorrhage, as compared to DSA, were 93.9%, 77.8%, 88.6% and 87.5%, respectively.

CONCLUSIONWhen compared with DSA, dual-phase CECT without CT angiography shows high sensitivity and positive predictive value for the detection of active haemorrhage in patients with blunt abdominopelvic trauma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; Observer Variation ; Pelvic Bones ; Pelvis ; injuries ; Radiology ; methods ; Retrospective Studies ; Wounds, Nonpenetrating ; diagnostic imaging ; Young Adult