radiologist

放射科医生
  • 文章类型: Journal Article
    背景:基于变压器的大型语言模型(LLM)的兴起,比如ChatGPT,人工智能(AI)的最新进展引起了全球的关注。ChatGPT在结构化放射学报告中显示出越来越大的潜力-AI传统上专注于图像分析的领域。
    方法:从开始到2024年5月对MEDLINE和Embase进行了全面搜索,并根据其内容选择了讨论ChatGPT在结构化放射学报告中的作用的主要研究。
    结果:在筛选的268篇文章中,8人最终被纳入本审查。这些文章探讨了ChatGPT的各种应用,例如从非结构化报告生成结构化报告,从自由文本中提取数据,从放射学发现中产生印象,并从成像数据中创建结构化报告。所有研究都对ChatGPT帮助放射科医生的潜力表示乐观,尽管常见的批评包括数据隐私问题,可靠性,医疗错误,缺乏医学专门培训。
    结论:ChatGPT和辅助AI具有改变放射学报告的巨大潜力,提高准确性和标准化,同时优化医疗保健资源。未来的发展可能涉及整合动态的少发提示,ChatGPT,和检索增强生成(RAG)到诊断工作流。继续研究,发展,道德监督对于充分发挥人工智能在放射学领域的潜力至关重要。
    BACKGROUND: The rise of transformer-based large language models (LLMs), such as ChatGPT, has captured global attention with recent advancements in artificial intelligence (AI). ChatGPT demonstrates growing potential in structured radiology reporting-a field where AI has traditionally focused on image analysis.
    METHODS: A comprehensive search of MEDLINE and Embase was conducted from inception through May 2024, and primary studies discussing ChatGPT\'s role in structured radiology reporting were selected based on their content.
    RESULTS: Of the 268 articles screened, eight were ultimately included in this review. These articles explored various applications of ChatGPT, such as generating structured reports from unstructured reports, extracting data from free text, generating impressions from radiology findings and creating structured reports from imaging data. All studies demonstrated optimism regarding ChatGPT\'s potential to aid radiologists, though common critiques included data privacy concerns, reliability, medical errors, and lack of medical-specific training.
    CONCLUSIONS: ChatGPT and assistive AI have significant potential to transform radiology reporting, enhancing accuracy and standardization while optimizing healthcare resources. Future developments may involve integrating dynamic few-shot prompting, ChatGPT, and Retrieval Augmented Generation (RAG) into diagnostic workflows. Continued research, development, and ethical oversight are crucial to fully realize AI\'s potential in radiology.
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  • 文章类型: Journal Article
    背景:几种类型的医疗保健专业人员在参与医疗保健系统的整个过程中负责癌症患者的护理。一种这样的类型是放射治疗师。放射治疗师不仅管理治疗,而且在治疗期间还直接参与患者。尽管和病人有直接接触,叙事倾向于更多地关注技术任务,而不是实际患者。这种以任务为中心的相互作用通常是由于涉及高度复杂的设备和复杂的放射治疗过程。这通常会导致无法满足患者的心理社会需求,和患者承认不遵守和延迟治疗的结果。
    目的:范围审查旨在探讨,图表,并绘制有关放射治疗中以人为中心的整体护理的现有文献,并确定和提出关键概念,定义,方法论,知识差距,以及与放射治疗中整体以人为本相关的证据。
    方法:该方案是使用先前描述的范围界定研究的方法学框架开发的。审查将包括同行评审和灰色文献,关于整体,放射治疗中以人为本的护理。已经为MEDLINE(Ovid)制定了全面的搜索策略,它将被翻译成其他包含的数据库:Scopus,CINAHL(EBSCO),MEDLINE(PubMed),Embase(Elsevier),科克伦图书馆,和开放获取期刊目录。灰色文献检索将包括谷歌(谷歌图书和谷歌学者),ProQuest,万维网网站,OpenGrey网站,以及各种大学论文和论文库。标题和摘要筛选,全文回顾,相关数据提取将由所有3名审稿人使用Covidence(VeritasHealthInnovation)软件独立进行,这也将被用来指导冲突的解决。选定的源将导入ATLAS。ti(阿特拉斯。ti科学软件开发有限公司)用于分析,它将包括内容分析,叙事分析,和描述性综合。结果将使用叙述方式呈现,图解,和表格格式。
    结果:该综述预计将发现研究差距,这些差距将为当前和未来的整体研究提供信息。放射治疗中以人为本的护理。审查于2023年11月开始,正式文献检索于2024年2月底完成。最终结果预计将在2025年之前发表在同行评审的期刊上。
    结论:本综述的结果预计将提供各种各样的策略,旨在提供全面的,放射治疗中以人为本的护理,以及找出文献中的一些空白。这些发现将用于为未来的研究提供信息,旨在设计,发展,评估,并实施改善整体的战略,放射治疗中以人为本的护理。
    DERR1-10.2196/51338。
    BACKGROUND: Several types of health care professionals are responsible for the care of patients with cancer throughout their engagement with the health care system. One such type is the radiotherapist. The radiotherapist not only administers treatment but is also directly involved with the patient during treatment. Despite this direct contact with the patient, the narrative tends to focus more on technical tasks than the actual patient. This task-focused interaction is often due to the highly sophisticated equipment and complex radiotherapy treatment processes involved. This often results in not meeting the psychosocial needs of the patient, and patients have acknowledged noncompliance and delayed treatment as a result.
    OBJECTIVE: The scoping review aims to explore, chart, and map the available literature on holistic person-centered care in radiotherapy and to identify and present key concepts, definitions, methodologies, knowledge gaps, and evidence related to holistic person-centered care in radiotherapy.
    METHODS: This protocol was developed using previously described methodological frameworks for scoping studies. The review will include both peer-reviewed and gray literature regarding holistic, person-centered care in radiotherapy. A comprehensive search strategy has been developed for MEDLINE (Ovid), which will be translated into the other included databases: Scopus, CINAHL (EBSCO), MEDLINE (PubMed), Embase (Elsevier), Cochrane Library, and the Directory of Open Access Journals. Gray literature searching will include Google (Google Books and Google Scholar), ProQuest, the WorldWideScience website, the OpenGrey website, and various university dissertation and thesis repositories. The title and abstract screening, full-text review, and relevant data extraction will be performed independently by all 3 reviewers using the Covidence (Veritas Health Innovation) software, which will also be used to guide the resolution of conflicts. Sources selected will be imported into ATLAS.ti (ATLAS.ti Scientific Software Development GmbH) for analysis, which will consist of content analysis, narrative analysis, and descriptive synthesis. Results will be presented using narrative, diagrammatic, and tabular formats.
    RESULTS: The review is expected to identify research gaps that will inform current and future holistic, person-centered care in radiotherapy. The review commenced in November 2023, and the formal literature search was completed by the end of February 2024. Final results are expected to be published in a peer-reviewed journal by 2025.
    CONCLUSIONS: The findings of this review are expected to provide a wide variety of strategies aimed at providing holistic, person-centered care in radiotherapy, as well as to identify some gaps in the literature. These findings will be used to inform future studies aimed at designing, developing, evaluating, and implementing strategies toward improved holistic, person-centered care in radiotherapy.
    UNASSIGNED: DERR1-10.2196/51338.
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  • 文章类型: Review
    医师职业倦怠的患病率继续增加,并不成比例地影响女医生。乳腺成像是女性主导的亚专业,因此,女医生日益恶化的职业倦怠可能会对乳腺成像行业的未来产生重大影响.系统和组织因素已被证明是超出个人因素的最大因素。根据梅奥模型,我们回顾了有关导致医师职业倦怠的7个主要组织因素及其对女性乳腺放射科医师的潜在不成比例影响的证据.讨论的主要组织因素是工作与生活的整合,控制和灵活性,工作量和工作需求,效率和资源,在工作中找到意义,工作中的社会支持和社区,组织文化和价值观。我们还提出了机构和实践的潜在策略,以减轻女性乳腺影像学放射科医生的倦怠。这些策略中的许多也可以使男性乳腺影像学放射科医师受益,他们也有倦怠的风险。
    Physician burnout continues to increase in prevalence and disproportionately affects women physicians. Breast imaging is a woman-dominated subspeciality, and therefore, worsening burnout among women physicians may have significant repercussions on the future of the breast imaging profession. Systemic and organizational factors have been shown to be the greatest contributors to burnout beyond individual factors. Based on the Mayo Model, we review the evidence regarding the 7 major organizational contributors to physician burnout and their potential disproportionate impacts on women breast radiologists. The major organizational factors discussed are work-life integration, control and flexibility, workload and job demands, efficiency and resources, finding meaning in work, social support and community at work, and organizational culture and values. We also propose potential strategies for institutions and practices to mitigate burnout in women breast imaging radiologists. Many of these strategies could also benefit men breast imaging radiologists, who are at risk for burnout as well.
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  • 文章类型: Journal Article
    目的:本范围审查旨在从医师的角度确定与接受人工智能/机器学习(AI/ML)支持的放射学实践创新相关的障碍和促成因素。
    方法:使用OvidMedline和Embase进行系统检索。关键词被用来生成包含计算机辅助诊断的精细查询,人工智能,障碍和推动者。三位审稿人评估了这些文章,第四个审稿人用于处理分歧。通过包括定量和定性研究来减轻偏倚的风险。
    结果:2000年1月至2023年的电子搜索确定了513项研究。发现12篇文章符合纳入标准:定性研究(n=4),调查研究(n=7),和随机对照试验(RCT)(n=1)。将人工智能应用到放射学实践中最常见的障碍是放射科医生对人工智能创新缺乏接受和信任;缺乏意识。知识,以及对技术的熟悉;以及对放射科医生专业自主权的感知威胁。最重要的AI实施推动者是对AI潜在附加值的高期望;减少诊断错误的潜力;在达到诊断时提高效率的潜力;以及提高患者护理质量的潜力。
    结论:这项范围审查发现,很少有专门设计的研究来确定在放射学实践中接受AI的障碍和促成因素。大多数研究都评估了人工智能取代放射科医生的看法,而不是采用人工智能的其他障碍或推动者。为了全面评估将AI创新整合到放射学实践中的潜在优势和劣势,收集关于利益相关者观点和态度的更有力的研究证据是至关重要的。
    This scoping review was conducted to determine the barriers and enablers associated with the acceptance of artificial intelligence/machine learning (AI/ML)-enabled innovations into radiology practice from a physician\'s perspective.
    A systematic search was performed using Ovid Medline and Embase. Keywords were used to generate refined queries with the inclusion of computer-aided diagnosis, artificial intelligence, and barriers and enablers. Three reviewers assessed the articles, with a fourth reviewer used for disagreements. The risk of bias was mitigated by including both quantitative and qualitative studies.
    An electronic search from January 2000 to 2023 identified 513 studies. Twelve articles were found to fulfill the inclusion criteria: qualitative studies (n = 4), survey studies (n = 7), and randomized controlled trials (RCT) (n = 1). Among the most common barriers to AI implementation into radiology practice were radiologists\' lack of acceptance and trust in AI innovations; a lack of awareness, knowledge, and familiarity with the technology; and perceived threat to the professional autonomy of radiologists. The most important identified AI implementation enablers were high expectations of AI\'s potential added value; the potential to decrease errors in diagnosis; the potential to increase efficiency when reaching a diagnosis; and the potential to improve the quality of patient care.
    This scoping review found that few studies have been designed specifically to identify barriers and enablers to the acceptance of AI in radiology practice. The majority of studies have assessed the perception of AI replacing radiologists, rather than other barriers or enablers in the adoption of AI. To comprehensively evaluate the potential advantages and disadvantages of integrating AI innovations into radiology practice, gathering more robust research evidence on stakeholder perspectives and attitudes is essential.
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  • 文章类型: Systematic Review
    背景。沉浸式虚拟现实(iVR)通过使外科医生能够在现实的三维环境中与复杂的解剖结构进行交互来促进手术决策。随着人们对其应用的兴趣,应该澄清其对患者和提供者的影响。本系统综述审查了目前关于iVR用于患者特定术前计划的文献。材料和方法。从2000年1月1日至2021年3月21日,对五个数据库的出版物进行了文献检索。关于外科医生在任何级别的针对患者特定的术前计划的培训中使用iVR模拟器的初步研究都是合格的。两名审稿人独立筛选标题,摘要,和全文,提取的数据,并使用多样化设计研究质量评估工具(QATSDD)评估质量。结果进行了定性合成,并计算描述性统计数据。结果。系统搜索总共产生了2555项研究,随后包括24篇全文用于定性综合,代表264名医务人员和460名患者。神经外科是最常见的学科(10/24;42%)。术前iVR并没有显著改善患者的手术时间,失血,并发症,和停留时间,但可能会减少透视时间。相比之下,iVR改善了手术策略的外科医生特定结果,解剖学可视化,和信心。有效性,可靠性,并评估了患者特异性iVR模型的可行性。纳入研究的平均QATSDD评分为32.9%。Conclusions.沉浸式VR改善了外科医生术前规划的体验,对短期患者预后影响的证据很少。未来的工作应该集中在调查长期患者预后的高质量研究上,以及术前iVR对学员的实用性。
    Background. Immersive virtual reality (iVR) facilitates surgical decision-making by enabling surgeons to interact with complex anatomic structures in realistic 3-dimensional environments. With emerging interest in its applications, its effects on patients and providers should be clarified. This systematic review examines the current literature on iVR for patient-specific preoperative planning. Materials and Methods. A literature search was performed on five databases for publications from January 1, 2000 through March 21, 2021. Primary studies on the use of iVR simulators by surgeons at any level of training for patient-specific preoperative planning were eligible. Two reviewers independently screened titles, abstracts, and full texts, extracted data, and assessed quality using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Results were qualitatively synthesized, and descriptive statistics were calculated. Results. The systematic search yielded 2,555 studies in total, with 24 full-texts subsequently included for qualitative synthesis, representing 264 medical personnel and 460 patients. Neurosurgery was the most frequently represented discipline (10/24; 42%). Preoperative iVR did not significantly improve patient-specific outcomes of operative time, blood loss, complications, and length of stay, but may decrease fluoroscopy time. In contrast, iVR improved surgeon-specific outcomes of surgical strategy, anatomy visualization, and confidence. Validity, reliability, and feasibility of patient-specific iVR models were assessed. The mean QATSDD score of included studies was 32.9%. Conclusions. Immersive VR improves surgeon experiences of preoperative planning, with minimal evidence for impact on short-term patient outcomes. Future work should focus on high-quality studies investigating long-term patient outcomes, and utility of preoperative iVR for trainees.
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  • 文章类型: Review
    UNASSIGNED:赞比亚的放射技师需要进行静脉(IV)插管和造影剂的给药,一个角色,传统上,是放射科医生。这种需求是由于放射科医师的短缺和对成像检查的需求增加。这篇综述旨在综合与X射线技师进行IV插管和造影剂管理有关的相关文献,以指导赞比亚的培训和实践。
    UNASSIGNED:在三个在线数据库(PubMed/MEDLINE,CINAHL,和ScienceDirect),射线照相杂志,并引用了参考文献,以确定有关放射科医师进行IV插管和造影剂给药的研究。
    UNASSIGNED:七项研究被确定并纳入本综述。调查结果总结为六个主题:好处和挑战,采用扩展角色,感染控制,安全性和并发症,医学法律问题,教育和培训。我们的发现表明,放射科医师主导的IV插管和造影剂的给药对影像学患者的管理做出了积极的贡献。
    UNASSIGNED:本次审查中确定的主题可以提供一个模板,说明在哪里建立培训方案和地方准则。在扩大放射技师的作用之前,实践范围应该扩大,并应制定经认可的培训计划和当地准则。
    UNASSIGNED: There has been a demand for radiographers in Zambia to perform intravenous (IV) cannulation and administration of contrast media, a role which, traditionally, was radiologists\'. This demand is due to a shortage of radiologists and an increase in demand for imaging examinations. This review aimed at synthesising relevant literature related to IV cannulation and administration of contrast media by radiographers to guide the training and practice in Zambia.
    UNASSIGNED: A structured literature search was conducted in three online databases (PubMed/MEDLINE, CINAHL, and ScienceDirect), radiography journals, and cited references to identify research studies on IV cannulation and administration of contrast media by radiographers.
    UNASSIGNED: Seven studies were identified and included in this review. The findings are summarised under six themes: benefits and challenges, adoption of the extended role, infection control, safety and complications, medico-legal issues, and education and training. Our findings revealed that radiographer-led IV cannulation and administration of contrast media contribute positively to the management of imaging patients.
    UNASSIGNED: The themes identified in this review could provide a template of where to base the establishment of the training programme and local guidelines. Before extending the role of radiographers, the scope of practice should be extended, and accredited training programme and local guidelines should be put in place.
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  • 文章类型: Journal Article
    A number of epidemiological studies have been conducted to investigate the health effects of low-dose radiation. The author reviewed epidemiological studies among radiologists, radiological technologists, and nuclear workers. Because the results of many epidemiological studies on these subjects have been published, and many studies have measured radiation doses, there is little uncertainty. In the studies among radiologists and radiological technologists, high risks for leukemia, skin cancer, and breast cancer were found in populations that began work before around 1950, but not seen such a tendency for those starting work recent years. The results of the studies among nuclear workers were inconsistent with some reporting that a risk was seen, while others reported no risk. The reason for this may be due to the different analysis methods among the studies.
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  • 文章类型: Journal Article
    背景:超声医师表现出高标准的诊断性能,并且具有相当大的专业独立性。在澳大拉西亚,超声检查者通常会生成初步报告,放射科医生会对其进行审查,并发布最终报告。这项研究的目的是确定超声医师报告为正常的病例是否需要放射科医师的检查。
    方法:本研究是对1000例超声检查者认为正常的腹部超声检查的回顾性回顾,随后由放射科医师报告。根据公认的定义,对放射科医师未报告的任何发现进行分析,并将其分为错误或差异。
    结果:1000次腹部检查包括244次完整的腹部检查,200肝胆,506个尿路和50个其他腹部检查。患者年龄<1至94岁(平均=35岁,中位数=32年)。美国检查由14名超声医师中的任何一名进行,时间为1-21年(平均=6年,中位数=7年)的临床经验。超声医师有两个诊断错误,放射科医师有两个错误。放射科医生没有发现任何急性或严重疾病的病例,需要入院或紧急临床检查的疾病,放射科医生也没有确定出现症状的原因。发现了18个差异,但这些都是微不足道的,大多数被专家临床医生评为无关紧要。
    结论:超声检查者在区分正常腹部超声检查方面是准确的。没有必要让放射科医生参与正常腹部US检查的第二次阅读。
    BACKGROUND: Sonographers demonstrate a high standard of diagnostic performance and work with a considerable degree of professional independence. In Australasia, sonographers typically generate a preliminary report which is reviewed by the radiologist who issues a final report. The aim of this study was to determine whether radiologist\'s review is required in cases reported as normal by the sonographer.
    METHODS: This study was a retrospective review of 1000 abdominal US examinations considered normal by sonographers that were subsequently reported by radiologists. Any findings reported by radiologists that were not reported by sonographers were analysed and separated into errors or discrepancies according to commonly accepted definition.
    RESULTS: The 1000 abdominal examinations included 244 complete abdominal, 200 hepatobiliary, 506 urinary tract and 50 other abdominal examinations. Patients\' age ranged from < 1 to 94 years (mean = 35 years, median = 32 years). US examinations were performed by any one of 14 sonographers with 1-21 years (mean = 6 years, median = 7 years) of clinical experience. Two diagnostic errors were made by sonographers and two errors by radiologists. In no single case did the radiologist uncover a case of an acute or serious illness, illness requiring admission or urgent clinical review, nor did the radiologist identify the cause for the presenting symptoms. Eighteen discrepancies were found, but these were of trivial nature and most were rated by specialist clinicians as irrelevant.
    CONCLUSIONS: Sonographers are accurate in distinguishing normal abdominal US examinations. The involvement of a radiologist in a second reading of normal abdominal US examinations is unnecessary.
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  • 文章类型: Journal Article
    OBJECTIVE. Most peer review programs focus on error detection, numeric scoring, and radiologist-specific error rates. The effectiveness of this method on learning and systematic improvement is uncertain at best. Radiologists have been pushing for a transition from an individually punitive peer review system to a peer-learning model. This national questionnaire of U.S. radiologists aims to assess the current status of peer review and opportunities for improvement. MATERIALS AND METHODS. A 21-question multiple-choice questionnaire was developed and face validity assessed by the ARRS Performance Quality Improvement subcommittee. The questionnaire was e-mailed to 17,695 ARRS members and open for 4 weeks; two e-mail reminders were sent. Response collection was anonymous. Only responses from board-certified, practicing radiologists participating in peer review were analyzed. RESULTS. The response rate was 4.2% (742/17,695), and 73.7% (547/742) met inclusion criteria. Most responders were in private practice (51.7%, 283/547) with a group size of 11-50 radiologists (50.5%) and in an urban setting (61.6%). Significant diversity was noted in peer review systems, with RADPEER used by less than half (45.0%) and cases selected most commonly by commercial software (36.2%) or manually (31.2%). There was no consensus on the number of required peer reviews per month (10-20 cases, 32.1%; > 20 cases, 29.1%; < 10 cases, 21.7%). Less than half (43.7%) did not use peer review for group education. Whereas most (67.7%) were notified of their peer review results individually, 21.5% were not notified at all. Around half were dissatisfied (44.5%) because of insufficient learning (94.0%) and inaccurate representation of their performance improvement (75.5%). Overall, the group discrepancy rates were unknown to most radiologists who participate in peer review (54.3%). Submission bias was the main reason for underreporting of serious discrepancies (49.0%). Most found four peer-learning methods feasible in daily practice: incidental observation, 65.1%; focused practice review, 52.9%; professional auditing, 45.8%; and blinded double reading, 35.4%. CONCLUSION. More than half of participants reported that peer review data are used for educational purposes. However, significant diversity remains in current peer review practice with no agreement on number of required reviews, method of case selection, and oversight of results. Nearly half of the radiologists reported insufficient learning, although most feel a better system would be feasible in daily practice.
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    文章类型: Journal Article
    目的:研究在磁共振(MR)成像中使用基于钆的造影剂(GBCAs)的风险,并探索降低可能存在肾源性系统纤维化(NSF)风险的患者不良反应可能性的策略。
    方法:搜索了3个学术数据库,以确定讨论GBCA不良反应的文章,特别是关于肾功能,在MR考试中。共分析了20篇同行评审的文章。
    结论:造影剂的安全性与螯合物键的稳定性有关(即,大环或线性)。肾功能下降或慢性肾脏疾病的患者对GBCA的不良反应风险较高;通常,对于有发生NSF风险的患者,大环造影剂被认为比线性造影剂更安全,因为它们具有更高的动力学稳定性.对于所有患者,应仔细遵守推荐剂量的钆,并结合美国放射学会定义的对比剂肾小球滤过率指南。
    结论:尽管在MR检查中使用对比剂有优势,技术人员应与转诊医师和放射科医师密切合作,以最大程度地降低肾功能下降患者发生NSF的风险.
    OBJECTIVE: To examine the risks of using of gadolinium-based contrast agents (GBCAs) in magnetic resonance (MR) imaging and explore strategies to reduce the likeliness of adverse effects in patients who might be at risk for developing nephrogenic system fibrosis (NSF).
    METHODS: A search of 3 scholarly databases was performed to identify articles that discuss adverse reactions to GBCAs, specifically relating to kidney function, in MR examinations. A total of 20 peer-reviewed articles were analyzed.
    CONCLUSIONS: Safety of contrast media is related to the stability of the chelate bond (ie, macrocyclic or linear). Patients who have decreased kidney function or chronic kidney disease are at higher risk for an adverse reaction to GBCAs; typically, macrocyclic contrast agents are considered safer than linear contrast agents for patients at risk for developing NSF because of their higher kinetic stability. Recommended doses of gadolinium should be adhered to carefully for all patients in conjunction with the glomerular filtration rate guidelines for contrast administration defined by the American College of Radiology.
    CONCLUSIONS: Although there are advantages to contrast use in MR examinations, technologists should work closely with referring physicians and radiologists to minimize risks for developing NSF in patients who have decreased kidney function.
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