radiologist

放射科医生
  • 文章类型: Journal Article
    睾丸扭转是一种医疗紧急情况,需要从紧急情况中立即采用多学科方法,外科,和放射服务。在这篇文章中,我们讨论了超声(US)在阴道内睾丸扭转诊断中的现有知识和日益增加的价值,以及我们在美国辅助下进行手动睾丸扭转的经验.睾丸扭转需要及时准确的诊断和快速的治疗措施。美国设备的技术进步和对这种病理学的了解使放射科医生处于诊断和管理的绝佳位置。在同样的医疗过程中,放射科医生既可以确认阴道内睾丸扭转,也可以尝试手动睾丸扭转。US辅助手动睾丸矫正是非侵入性的,简单,快,安全,能迅速恢复睾丸血流的有效动作,最大限度地挽救睾丸,缓解患者的症状,并促进手术。
    Testicular torsion is a medical emergency that requires an immediate and multidisciplinary approach from emergency, surgical, and radiological services. In this article, we discuss the current knowledge and growing value of ultrasound (US) for intravaginal testicular torsion diagnosis and our experience with manual testicular detorsion with US assistance. Testicular torsion requires prompt and accurate diagnosis and quick therapeutic action. Technological advances in US equipment and knowledge of this pathology place the radiologist in an excellent position for its diagnosis and management. During the same medical procedure, the radiologist can both confirm the intravaginal testicular torsion and attempt manual testicular detorsion. US-assisted manual testicular detorsion is a non-invasive, simple, quick, safe, and effective manoeuvre that can rapidly restore testicular blood flow, maximising testicular salvage, relieving the patient\'s symptoms, and facilitating surgery.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    扩散加权成像(DWI)广泛用于神经放射学或腹部成像,但尚未在肌肉骨骼肿瘤的诊断中实施。
    本研究旨在评估肌肉骨骼肿瘤患者的MRI方案中包括扩散成像如何影响放射科医师与非放射科医师之间的一致性。
    39例肌肉骨骼肿瘤患者(尤文肉瘤,骨肉瘤,包括在我们机构咨询的良性肿瘤)。具有不同经验水平的三名评估者评估了对所有临床数据不知情的检查。最终诊断由共识确定。MRI检查分为1)常规序列和2)常规序列结合DWI。我们评估了是否存在扩散限制,固体性质,坏死,深度本地化,和直径>4厘米作为已知的恶性肿瘤的放射学标记。评估者之间的协议使用Gwet的AC1系数进行了评估,并根据Landis和Koch进行了解释。
    两组评估者的扩散限制协议最低。所有评估者之间的协议范围从0.51到0.945,表明中等到几乎完美的协议,和0.772-0.965在只有放射科医生表明实质上几乎完美的协议。
    评估扩散加权MRI序列的一致性低于常规MRI序列,在放射科医师和非放射科医师之间以及仅放射科医师之间。这表明评估扩散成像更具挑战性,和经验可能会影响协议。
    UNASSIGNED: Diffusion-weighted imaging (DWI) is widely used in neuroradiology or abdominal imaging but not yet implemented in the diagnosis of musculoskeletal tumors.
    UNASSIGNED: This study aimed to evaluate how including diffusion imaging in the MRI protocol for patients with musculoskeletal tumors affects the agreement between radiologists and non-radiologist.
    UNASSIGNED: Thirty-nine patients with musculoskeletal tumors (Ewing sarcoma, osteosarcoma, and benign tumors) consulted at our institution were included. Three raters with different experience levels evaluated examinations blinded to all clinical data. The final diagnosis was determined by consensus. MRI examinations were split into 1) conventional sequences and 2) conventional sequences combined with DWI. We evaluated the presence or absence of diffusion restriction, solid nature, necrosis, deep localization, and diameter >4 cm as known radiological markers of malignancy. Agreement between raters was evaluated using Gwet\'s AC1 coefficients and interpreted according to Landis and Koch.
    UNASSIGNED: The lowest agreement was for diffusion restriction in both groups of raters. Agreement among all raters ranged from 0.51 to 0.945, indicating moderate to almost perfect agreement, and 0.772-0.965 among only radiologists indicating substantial to almost perfect agreement.
    UNASSIGNED: The agreement in evaluating diffusion-weighted MRI sequences was lower than that for conventional MRI sequences, both among radiologists and non-radiologist and among radiologists alone. This indicates that assessing diffusion imaging is more challenging, and experience may impact the agreement.
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  • 文章类型: Journal Article
    目的:评估1998年至2023年美国与人工智能(AI)和放射学有关的媒体报道的频率和内容。
    方法:在ProQuestUSNewsstream数据库中查询了1998年1月1日至2023年3月30日之间发表的提及AI和放射学的印刷和在线文章。使用与放射学和AI相关的术语的布尔搜索用于检索全文和出版物信息。具有放射学专业知识的9位读者之一使用标准化评分系统独立审查了随机分配的文章。
    结果:379篇文章符合纳入标准,其中290篇是独一无二的,89篇是银团文章。大多数人对人工智能有积极的看法(74%),而负面情绪则不那么普遍(9%)。积极情绪的频率在专注于AI和放射学的文章中最高(86%),而在专注于AI和非医学主题的文章中最低(55%)。人工智能对放射学的净影响最常见的是积极的(60%)。人工智能的好处(76%)比潜在的危害(46%)更频繁地被提及。在不到三分之一的文章中,放射科医生接受了采访或引用。
    结论:在美国媒体报道中,人工智能对放射学的影响大多是积极的,人工智能的优势比潜在风险更频繁地被讨论。然而,与更专注于医学和放射学的文章相比,一般非医学领域的文章更有可能对AI对放射学的影响产生负面看法.放射科医生很少在媒体报道中接受采访或引用。
    OBJECTIVE: To evaluate the frequency and content of media coverage pertaining to artificial intelligence (AI) and radiology in the United States from 1998 to 2023.
    METHODS: The ProQuest US Newsstream database was queried for print and online articles mentioning AI and radiology published between January 1, 1998, and March 30, 2023. A Boolean search using terms related to radiology and AI was used to retrieve full text and publication information. One of 9 readers with radiology expertise independently reviewed randomly assigned articles using a standardized scoring system.
    RESULTS: 379 articles met inclusion criteria, of which 290 were unique and 89 were syndicated articles. Most had a positive sentiment (74 %) towards AI, while negative sentiment was far less common (9 %). Frequency of positive sentiment was highest in articles with a focus on AI and radiology (86 %) and lowest in articles focusing on AI and non-medical topics (55 %). The net impact of AI on radiology was most commonly presented as positive (60 %). Benefits of AI were more frequently mentioned (76 %) than potential harms (46 %). Radiologists were interviewed or quoted in less than one-third of all articles.
    CONCLUSIONS: Portrayal of the impact of AI on radiology in US media coverage was mostly positive, and advantages of AI were more frequently discussed than potential risks. However, articles with a general non-medical focus were more likely to have a negative sentiment regarding the impact of AI on radiology than articles with a more specific focus on medicine and radiology. Radiologists were infrequently interviewed or quoted in media coverage.
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  • 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
    提高妇女在放射科的地位对于更好的工作环境至关重要。商界有强有力的证据表明,女性领导人通过提高工作场所的财务可行性和加强合作来改善工作场所,工作满意度,和订婚。多样化的领导力促进创新,女性以独特的见解和协作方式解决问题。领导力中的性别多样性与改善患者预后相关,因为女性领导者优先考虑以患者为中心的护理和沟通。妇女创造可持续的,生产性工作和改善放射学。女性是强有力的榜样,激励下一代女性在放射学和解决性别差异。增加放射学领域的女性领导者对于增加放射学领域的女性人数至关重要。本文总结了女性在担任领导角色时面临的许多挑战:组织偏见优先考虑男性观点,边缘化女性的声音和贡献,缺乏榜样,缺乏时间(“第二班次”),缺乏自信,缺乏兴趣或感知到的利益,缺乏支持,倦怠,和以前的糟糕经历。虽然系统性问题难以克服,本文通过提供策略来提高工作满意度并为领导带来新的有价值的观点,从而帮助培训和发展女性放射科医生。
    Improving the status of women in radiology is crucial to better work environments. There is strong evidence in the business world that women leaders improve the workplace by making it more financially viable and by increasing collaboration, job satisfaction, and engagement. Diverse leadership fosters innovation, and women approach problem-solving with unique insights and collaborative styles. Gender diversity in leadership correlates with improved patient outcomes because women leaders prioritize patient-centered care and communication. Women create sustainable, productive work and improve radiology. Women serve as powerful role models, inspiring the next generation of women in radiology and addressing gender disparities. Increasing women leaders in radiology is essential to increase the number of women in radiology. This article summarizes many challenges women face when taking leadership roles: organizational biases prioritizing male viewpoints and marginalizing women\'s voices and contributions, a lack of role models, a lack of time (\"second shift\"), a lack of confidence, a lack of interest or perceived benefit, a lack of support, burnout, and previous poor experiences. While systemic issues are difficult to overcome, this article assists in the training and development of women radiologists by offering strategies to enhance job satisfaction and bring new and valuable perspectives to leadership.
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  • 文章类型: Journal Article
    本研究旨在调查全科医生(全科医生)和放射科医生对转诊的看法,成像理由,和不必要的成像在挪威。
    调查涵盖了成像,责任,对正当性评估的态度,转介过程,和人口统计使用多项选择题,声明报告同意使用李克特量表和一个悬而未决的问题。
    参加全国会议的40名放射科医生和58名全科医生完成了一项基于网络的调查,20/15%的反应率,分别。放射科医生(97%)和全科医生(100%)都考虑避免不必要的检查,这对他们在医疗保健服务中的作用至关重要。尽管如此,91%的全科医生承认他们提到他们认为没有帮助的成像,而大约60%的放射科医生认为在他们的工作场所进行了不必要的成像。全科医生报告说,来自患者和拥有私人保险的患者的压力是进行不必要检查的最常见原因。相比之下,放射科医师报告缺乏临床信息,无法与全科医生讨论患者病例是最常见的原因.
    这项研究增加了我们对放射科医生和全科医生对不必要的成像和转诊的理解。更好的指导方针,更重要的是,引荐者和放射科医生之间需要更好的沟通。解决这些问题可以减少不必要的成像并提高护理质量和安全性。
    UNASSIGNED: This study aimed to survey general practitioners\' (GPs) and radiologists\' perspectives on referrals, imaging justification, and unnecessary imaging in Norway.
    UNASSIGNED: The survey covered access to imaging, responsibilities, attitudes toward justification assessment, referral process, and demographics using multiple choice questions, statements to report agreement with using the Likert scale and one open question.
    UNASSIGNED: Forty radiologists and 58 GPs attending national conferences completed a web-based survey, with a 20/15% response rate, respectively. Both radiologists (97%) and GPs (100%) considered avoiding unnecessary examinations essential to their role in the healthcare service. Still, 91% of GPs admitted that they referred to imaging they thought was not helpful, while about 60% of the radiologists agreed that unnecessary imaging was conducted in their workplace. GPs reported pressure from patients and patients having private insurance as the most common reasons for doing unnecessary examinations. In contrast, radiologists reported a lack of clinical information and the inability to discuss patient cases with the GPs as the most common reasons.
    UNASSIGNED: This study adds to our understanding of radiologists\' and GPs\' perspectives on unnecessary imaging and referrals. Better guidelines and, even more importantly, better communication between the referrer and the radiologist are needed. Addressing these issues can reduce unnecessary imaging and improve the quality and safety of care.
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  • 文章类型: Journal Article
    背景:胰腺囊性病变(PCL)是计算机断层扫描(CT)扫描中常见且未报道的偶然发现,并且可以发展为胰腺癌-最致命的癌症,预期寿命不到5个月。
    目的:本研究的目的是开发和验证一种人工深度神经网络(注意门U-Net,也称为“AGNet”),用于自动检测PCL。这种技术可以帮助放射科医师应对日益增长的横断面影像检查需求,增加偶然发现的PCL数量,从而增加胰腺癌的早期检测。
    方法:我们调整并评估了一种基于注意力门U-Net架构的算法,用于在CT上自动检测PCL。共有335个具有PCL和对照病例的腹部CT由2名放射科医师在3D中手动分割,这些放射科医师具有超过10年的经验,并与专门从事腹部放射学的董事会认证放射科医师达成共识。该信息用于训练用于分割的神经网络,然后是过滤网络结果并应用一些物理约束的后处理管道,比如胰腺的预期位置,以尽量减少误报的数量。
    结果:在这项研究中纳入的335项研究中,297有一个PCL,包括浆液性囊腺瘤,导管内假乳头状黏液瘤,黏液囊性肿瘤,和假性囊肿。所选数据集的Shannon指数为0.991,均匀度为0.902。检测这些病变的平均灵敏度为93.1%(SD0.1%),特异性为81.8%(SD0.1%)。
    结论:这项研究表明,在非对比增强和对比增强腹部CT扫描中,自动人工深度神经网络在检测PCL方面具有良好的性能。
    BACKGROUND: Pancreatic cystic lesions (PCLs) are frequent and underreported incidental findings on computed tomography (CT) scans and can evolve to pancreatic cancer-the most lethal cancer, with less than 5 months of life expectancy.
    OBJECTIVE: The aim of this study was to develop and validate an artificial deep neural network (attention gate U-Net, also named \"AGNet\") for automated detection of PCLs. This kind of technology can help radiologists to cope with an increasing demand of cross-sectional imaging tests and increase the number of PCLs incidentally detected, thus increasing the early detection of pancreatic cancer.
    METHODS: We adapted and evaluated an algorithm based on an attention gate U-Net architecture for automated detection of PCL on CTs. A total of 335 abdominal CTs with PCLs and control cases were manually segmented in 3D by 2 radiologists with over 10 years of experience in consensus with a board-certified radiologist specialized in abdominal radiology. This information was used to train a neural network for segmentation followed by a postprocessing pipeline that filtered the results of the network and applied some physical constraints, such as the expected position of the pancreas, to minimize the number of false positives.
    RESULTS: Of 335 studies included in this study, 297 had a PCL, including serous cystadenoma, intraductal pseudopapillary mucinous neoplasia, mucinous cystic neoplasm, and pseudocysts . The Shannon Index of the chosen data set was 0.991 with an evenness of 0.902. The mean sensitivity obtained in the detection of these lesions was 93.1% (SD 0.1%), and the specificity was 81.8% (SD 0.1%).
    CONCLUSIONS: This study shows a good performance of an automated artificial deep neural network in the detection of PCL on both noncontrast- and contrast-enhanced abdominal CT scans.
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  • 文章类型: Journal Article
    目标:从2021年到2023年,进入放射学住院医师和神经放射学研究金的国际医学毕业生(IMG)人数平均分别为9.7%和20.9%。我们旨在确定IMG毕业生是否在诊断放射学(DR)和神经放射学中以成比例的比例增加领导角色。
    方法:我们调查了191名DR项目主管,94名神经放射学项目主任(PD),192把放射学椅子,和91名神经放射学主任询问他们最初的公民身份和医学院(美国医学毕业生[AMG]vsIMG)。我们审查了机构网站,以获取缺失的数据,并记录了使用Scopus的每个人的H指数。
    结果:我们确认了每个领导小组中61-75%和93-98%的原始公民身份和医学院所在地。我们发现16.2%的DR项目主管,43.7%的神经放射学PD,28.5%的椅子,40.6%的神经放射学主任最初不是美国公民。IMG率为18/188(9.6%),20/90(22.2%),26/186(14.0%),同一组分别为19/85(22.4%)。对于所有领导团体,最常见的原籍国和医学院都是印度。IMG的中位数H指数为14,而AMG为10,差异显着(p=0.021)结论:与2021年至2023年进入诊断和神经放射学的学员比率相比,IMG在所研究的领导职位中占比例。IMG的H指数高于AMG。我们得出的结论是,IMG在放射学和神经放射学领导方面取得了实质性和相称的进展。
    OBJECTIVE: The number of international medical graduates (IMGs) entering radiology residencies and neuroradiology fellowships averaged 9.7% and 20.9% from 2021 to 2023, respectively. We aimed to determine whether IMG graduates are populating leadership roles at a proportionate rate in diagnostic radiology (DR) and neuroradiology.
    METHODS: We surveyed 191 DR program directors, 94 neuroradiology program directors (PDs), 192 chairs of radiology, and 91 directors of neuroradiology inquiring about their original citizenship and medical school (American Medical Graduates [AMG] vs IMG). We reviewed institutional websites to obtain missing data and recorded H indices for each person using Scopus.
    RESULTS: We confirmed the original citizenship and medical school location in 61-75% and 93-98% of each leadership group. We found that 16.2% of DR program directors, 43.7% of neuroradiology PDs, 28.5% of Chairs, and 40.6% of neuroradiology directors were not originally US citizens. The IMG rate was 18/188 (9.6%), 20/90 (22.2%), 26/186 (14.0%), and 19/85 (22.4%) for the same groups respectively. The most common country of origin and medical school cited was India for all leadership groups. IMGs had a median H index of 14 while AMG 10, significantly different (p = 0.021) CONCLUSION: Compared to the rate of diagnostic and neuroradiology trainees entering from 2021 to 2023, IMGs are proportionately represented at the leadership positions studied. The H index of the IMGs was higher than AMG. We conclude that IMGs have made substantial and proportionate inroads in radiology and neuroradiology leadership.
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  • 文章类型: Journal Article
    目的:使用深度学习方法,使用单模态T2加权成像非侵入性检测前列腺癌并预测Gleason分级。
    方法:前列腺癌患者,经组织病理学证实,2015年9月至2022年6月期间在我们医院接受磁共振成像检查的患者被回顾性纳入内部数据集.来自另一个医疗中心的外部数据集和公共挑战数据集用于外部验证。设计了一种深度学习方法用于前列腺癌检测和Gleason等级预测。计算曲线下面积(AUC)以比较模型性能。
    结果:对于前列腺癌检测,内部数据集包括来自195名健康个体(年龄:57.27±14.45岁)和302名诊断为前列腺癌的患者(年龄:72.20±8.34岁)的数据.在验证集中我们的前列腺癌检测模型的AUC(n=96,19.7%)为0.918。对于格里森品位预测,数据集包括来自302名前列腺癌患者中的283名的数据,227名(年龄:72.06±7.98岁)和56名(年龄:72.78±9.49岁)患者正在接受培训和测试,分别。外部和公共挑战数据集包括来自48名患者(年龄:72.19±7.81岁)和91名患者(年龄信息不可用)的数据。分别。我们在训练集中的格里森等级预测模型的AUC(n=227)为0.902,而那些验证(n=56),外部验证(n=48),和公共挑战验证集(n=91)分别为0.854,0.776和0.838.
    结论:通过多中心数据集验证,我们提出的深度学习方法可以检测前列腺癌,并比人类专家更好地预测Gleason等级。
    精确的前列腺癌检测和Gleason分级预测对临床治疗和决策具有重要意义。
    结论:对于放射科医生来说,前列腺分割比前列腺癌病灶更容易注释。我们的深度学习方法检测到前列腺癌并预测Gleason分级,表现优于人类专家。非侵入性Gleason等级预测可以减少不必要的活检次数。
    OBJECTIVE: To noninvasively detect prostate cancer and predict the Gleason grade using single-modality T2-weighted imaging with a deep-learning approach.
    METHODS: Patients with prostate cancer, confirmed by histopathology, who underwent magnetic resonance imaging examinations at our hospital during September 2015-June 2022 were retrospectively included in an internal dataset. An external dataset from another medical center and a public challenge dataset were used for external validation. A deep-learning approach was designed for prostate cancer detection and Gleason grade prediction. The area under the curve (AUC) was calculated to compare the model performance.
    RESULTS: For prostate cancer detection, the internal datasets comprised data from 195 healthy individuals (age: 57.27 ± 14.45 years) and 302 patients (age: 72.20 ± 8.34 years) diagnosed with prostate cancer. The AUC of our model for prostate cancer detection in the validation set (n = 96, 19.7%) was 0.918. For Gleason grade prediction, datasets comprising data from 283 of 302 patients with prostate cancer were used, with 227 (age: 72.06 ± 7.98 years) and 56 (age: 72.78 ± 9.49 years) patients being used for training and testing, respectively. The external and public challenge datasets comprised data from 48 (age: 72.19 ± 7.81 years) and 91 patients (unavailable information on age), respectively. The AUC of our model for Gleason grade prediction in the training set (n = 227) was 0.902, whereas those of the validation (n = 56), external validation (n = 48), and public challenge validation sets (n = 91) were 0.854, 0.776, and 0.838, respectively.
    CONCLUSIONS: Through multicenter dataset validation, our proposed deep-learning method could detect prostate cancer and predict the Gleason grade better than human experts.
    UNASSIGNED: Precise prostate cancer detection and Gleason grade prediction have great significance for clinical treatment and decision making.
    CONCLUSIONS: Prostate segmentation is easier to annotate than prostate cancer lesions for radiologists. Our deep-learning method detected prostate cancer and predicted the Gleason grade, outperforming human experts. Non-invasive Gleason grade prediction can reduce the number of unnecessary biopsies.
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