Listen in as our team of senior resident and fellow Podcast Editors critique articles and provide synthesized overviews of timely research from the “Yellow Journal” for in-training and practicing radiologists.
Conventional vs. Drug Eluting Bead TACE - The Debate Continues [critique of article by Zhang et al.]
David Ballard, MD discusses an important contribution to the literature in assessing the ongoing debate of conventional vs. drug eluting bead transarterial chemoembolization.
The Potential of a Patient Symptom Questionnaire and its Potential Role in Improving Diagnostic Specificity of Pain Generators for Lumbar Spine MRI [critique of article by Balza et al.]
Identifying primary pain generators with lumbar spine MRI can be a challenging task. Adequate patient symptom information is often lacking and its absence may allow radiologists astray in their own interpretations. Drew Guino, MD discusses the development of a patient symptom questionnaire appears to address this very issue, however.
18F-Fluciclovine PET/MRI: Too Little, Too Late? [critique of article by Galgano et al.]
David Robinson, MD discusses an AJR pilot study exploring 18F-Fluciclovine PET/MRI for initial staging of prostate cancer and the effects of androgen deprivation therapy on 18F-Fluciclovine uptake.
Normal Range MRI-derived Left Ventricular Global Strain – Is It Ready for Primetime? [critique of article by Smith et al.]
Giuseppe V. Toia, MD reviews a timely meta-analysis which defines the normal reference ranges for MRI-derived left ventricular strain in healthy adults.
Chest CT Findings of Immune Checkpoint Inhibitor Therapy-Related Adverse Events [critique of article by Smith et al.]
Kerem Ozturk, MD discusses why awareness of early chest CT findings is required for early detection and accurate diagnosis of immune checkpoint inhibitor therapy-related adverse events such as pneumonitis, new consolidation, worsening thoracic tumor burden, pleural/pericardial effusion, and pulmonary emboli in the emergency department.
Gadolinium deposition in pediatric brains when using gadobutrol and other macrocyclic agents [critique of article by Ozturk et al.]
Tyler Richards, MD discusses an AJR article that found no significant increase in the intrinsic T1 signal in the globus pallidus and dentate nucleus after more than 10 administrations of gadobutrol in pediatric patients compared to matched-age gadolinium naïve control and discussion of similar imaging based and autopsy studies.
Chest Radiograph as Predictor and Clinical Guide for Management of Patients with COVID-19: Current Studies and Future Direction [critique of article by Reeves et al.]
In this podcast, Pei-Kang (Ken) Wei, MD and Diana Litmanovich, MD first summarized the study by Reeves et al. and then provided an in-depth discussion about the current status and future direction of utilizing chest radiograph as a guiding tool for clinical management. Key aspects of the discussion are the practicality and applicability of the scoring system developed by Reeves et al., chest radiograph as a more desirable modality for evaluating patients with COVID-19 compared to CT, and chest radiograph as an outcome predictor.
Findings of COVID-related Disseminated Leukoencephalopathy [critique of article by Freeman et al.]
While the primary manifestations of COVID-19 are respiratory in nature—it has become clear as we take care of patients and learn more that COVID can have an effect on the nervous system. On this podcast, Edgar Perez, MD discusses MRI findings of COVID related-Disseminated Leukoencephalaopathy, which should remain an important differential consideration in COVID patients with neurologic manifestations.
Radiofrequency Tag Localization Is a Feasible Alternative to Wire Localization of Breast Lesions [critique of article by Lamb et al.]
Wire localization has long been the standard of care for localization of non-palpable breast lesions. Additional wireless localization options exist, including use of radioactive seeds, magnetic markers, radar/infrared reflectors, or most recently a radiofrequency identification tags, which address some of the disadvantages involved in wire localization. Matthew Petterson, MD discusses results an AJR study of one year of use at a single institution that suggests that RF tag localization is a feasible alternative to wire localization.
Borderline Resectable and Locally Advanced Pancreas Cancer: FDG PET/MRI and CT Tumor Metrics for Assessment of Neoadjuvant Therapy Pathologic Response and Prediction of Survival [critique of article by Panda et al.]
Patients with borderline resectable and locally advanced pancreatic cancer receiving neoadjuvant therapy can have results comparable to patients with resectable tumor at presentation, however some patients have early recurrence after neoadjuvant therapy and resection. Jordan Perchik, MD discusses a new AJR study in which a team of radiologists evaluate multiple imaging parameters and tumor metrics to assess for characteristics to predict pathologic response prior to resection.
Use of Enteric Contrast for Abdominopelvic CT in Penetrating Traumatic Injury in Adults [critique of article by Alabousi et al.]
Michael Nellamattathil, DO discusses whether or not enteric contrast is necessary in the setting of penetrating traumatic injury in light of a recent AJR article on the subject.
Thermal Ablation versus stereotactic body radiation therapy following trans-arterial chemoembolization – A comparison of outcomes [critique of article by Nabavizadeh et al.]
Percutaneous interventions are the mainstay for patients with non-operative HCC. This podcast by Ben Kipper, MD examines a paper comparing outcomes between thermal ablation and stereotactic body radiation therapy following transarterial chemoembolization and how those outcomes might affect clinical treatment plans going forward.
Malignant Outcomes of Architectural Distortion [critique of article by Choudhery et al.]
Architectural distortion is a subtle but suspicious finding increasingly detected using digital breast tomosynthesis. Alicia Chen, MD discusses a timely meta-analysis by Dr. Choudhery and colleagues that found the pooled positive predictive value for AD without a known cause on DBT is 35%, the great majority of which represents invasive disease. This finding warrants tissue sampling.
Ultrasound guided percutaneous biopsy of small pleural lesions [critique of article by Park et al.]
In this episode, Yoon-Jin Kim, MD discusses a study evaluating the diagnostic yield of ultrasound guided percutaneous biopsy of small pleural lesions. Important findings include that the technique is safe and fairly high yield for lesions 20 mm or less and that features such as nodular.
Evaluating PI-RADS 3 atypical BPH nodules using v2.1 [critique of article by Costa et al.]
Jeff Guccione, MD discusses a new article comparing atypical BPH prostatic nodules in the problematic prostate transition zone to traditional PI-RADS 3 lesions using PI-RADS version 2.1. All nodules contain pathologic confirmation from biopsy.
Prediction of Stroke Recurrence: A Comparison of Transthoracic Echocardiography, Cardiac CTA, and Cardiac MRI in Patients with Suspected Cardioembolic Stroke [critique of article by Apfaltrer et al.]
Transthoracic echocardiography (TTE) is the standard of care in cardiac imaging for patients with suspected cardioembolic stroke. In this podcast, Amber Liles, MD discusses how cardiac MRI and cardiac CT angiography perform in comparison to TTE in terms of prediction of stroke recurrence.
Can an unconventional diffusion weighted technique aid in the MRI management of sacroiliitis? [critique of article by Zhang et al.]
Shrey Patel, MD discusses a new AJR article on whether using an unconventional DWI technique, readout-segmented echo-planar imaging, can improve image quality and differentiate disease activity in patients with axial spondyloarthritis.
CT and MR perform similarly using Bosniak v2019 for cystic renal masses [critique of article by Tse et al.]
In this episode, David Ballard, MD summarizes Bosniak version 2019 (v2019) and Tse et al.’s imaging cohort with study radiologists applying Bosniak v2019.
Liver steatosis categorization on contrast-enhanced CT using a fully-automated deep learning volumetric segmentation tool: Evaluation in 1,204 healthy adults using unenhanced CT as the reference standard [critique of article by Pickhardt et al.]
Shrav Sridhar, MD discusses a retrospective study in which automated volumetric segmentation-assisted hepatic parenchymal attenuation measurement was performed on contrast-enhanced and unenhanced abdominal CT scans of a cohort of healthy adults to investigate the possibility of stratifying liver fat content on contrast-enhanced CT.
Increasing Specificity of Recommendations for Renal Incidentalomas [critique of article by Corwin et al.]
Incidentally detected renal masses are common, and can require follow-up. Recommendations from the 2017 ACR white paper on incidental renal masses suggests that small homogeneous masses measuring less than 20 Hounsfield units are probably benign, and do not require further characterization. However, new evidence from a multi-institutional study in AJR suggests that this cutoff should be raised to at least 30 Hounsfield units. In this episode, Matthew Petterson, MD discusses the new evidence.
Treating Sinistral Portal Hypertension: Stenting or Embolization? A first-of-its-kind study. [critique of article by Wei et al.]
Frederic J. Bertino, MD reviews a new AJR study in which the authors attempt to compare the clinical efficacy and technical feasibility of Splenic vein stenting and splenic artery embolization (the current standard) for the treatment of SPH.
A New Medial Meniscal Extrusion Threshold Relating Clinical Symptoms and MRI Findings [critique of article by Liu et al.]
The addition of clinical information and verified cartilage damage progression on MRI may represent a new standard in determining progression of knee osteoarthritis. Drew Gunio, MD, MS discusses a new AJR article on why 2.5 mm may now be the new number to consider when reporting medial meniscal extrusion.
Altar of the Hounsfield Unit [critique of article by Azar et al.]
Can HU reliably differentiate any benign sclerotic bone lesion (not just bone islands) from sclerotic metastases? David Robinson, MD explores the topic through the lens of a new AJR article on the subject.
Improving radiologist performance in detection of microinvasive disease on mammography [critique of article by Grimm et al.]
Jordan Perchik, MD discusses a new AJR study in which a team of breast imaging radiologists determine if case review and a targeted educational session can improve detection of microinvasive disease on mammography. The authors describe patterns key to upstaging DCIS and address the difficulty and limitations of detecting microinvasive disease.
A Look at Thermal Ablation of RCC in the Morbidly Obese [critique of article by Zhou et al.]
In this podcast, Edgar Perez, MD reviews new AJR data on how ablation fares in the morbidly obese demographic. Additionally, this podcast may help facilitate discussions about expectations, safety, efficacy, and complications during consultations with morbidly obese patients.
Predictors of Anesthetic Exposure in Pediatric MRI [critique of article by Machado-Rivas et al.]
Michael Nellamattathil, MD analyzes and reviews a recent AJR article on the various factors contributing to anesthesia time and exposure in pediatric patients undergoing MRI examinations and what can be done to improve these measures.
Comparing Chest CT findings in Coronavirus and Influenza Pneumonias [critique of article by Lin et al.]
Jeffrey Guccione, MD highlights the keys points of a new AJR article, which retrospectively compares the imaging features on CT of coronavirus pneumonia and influenza. The importance of this research is put into the broader context of the evolving COVID-19 pandemic, including the possibility for concurrent outbreaks of SARS-CoV-2 and influenza. The strengths and weaknesses are outlined along with some future avenues for investigation.
Stroke and COVID-19: A New Association [critique of article by Kihira et al.]
COVID 19 has been shown to affect a variety of organ systems. In this podcast, Ben Kipper, MD examines the association between stroke subtypes and COVID-19 as well as the effect that association may have on clinicians and radiologists.
Lung US Findings in Coronavirus Disease-19 (COVID-19) Patients [critique of article by Zhang et al.]
On this episode, Alicia Chen, MD takes a closer look at a very timely new AJR article titled, “Lung US Findings in Coronavirus Disease-19 (COVID-19) Patients” by Yao Zhang and colleagues from Beijing Ditan Hospital and Peking University Third Hospital. Compared to CT, ultrasound is portable, less costly, and does not use radiation.
Factors Associated with Background Parenchymal Enhancement on Contrast Enhanced Mammography [critique of article by Karimi et al.]
In this episode, Yoon-Jin Kim, MD discusses a study evaluating factors associated with background parenchymal enhancement (BPE) on contrast-enhanced mammography. The findings are important as BPE impacts study interpretation and high BPE may be an independent breast cancer risk factor. The study findings are valuable for physicians currently interpreting this emerging breast imaging modality and those considering integrating it into their own clinical practice.
ACR TI-RADS: What Are We Missing? [critique of article by Smith et al.]
Compared to other guidelines, ACR TI-RADS results in a decreased number of thyroid nodules which are either followed or given a recommendation of fine needle aspiration (FNA). Find out on this podcast hosted by Amber Liles, MD, MPH, what thyroid malignancies are missed and why and how changes in size thresholds might affect ACR TI-RADS performance and outcomes.
Whole-Body Bone Scintigraphy Helps to Detect Kidney Diseases [critique of article by Zhao et al.]
Shravan Sridhar, MD, MS discusses a new retrospective review of patients with abnormal renal uptake Technicium 99m MDP bone scans in which the causes of abnormal renal uptake, imaging follow up, and interventions are assessed
Opportunistic Screening for Metabolic Syndrome in Asymptomatic Adults Utilizing Fully Automated Abdominal CT-based Biomarkers [critique of article by Pickhardt et al.]
Metabolic syndrome is typically thought of as a clinical disease. In this podcast, Shrey Patel, MD discusses a new study in AJR that on reevaluating the role of imaging in identifying and potentially diagnosing patients at risk for metabolic syndrome by using CT biomarkers.