AJNR Tweetchat Recap – Imaging 3.0

For this month’s #AJNR Tweetchat, ACR thought leaders @RichDuszak and @MattHawkinsMD, both from Emory University, joined us to discuss the ACR’s “Imaging 3.0″ initiative to combat the commoditization of Radiologists and increase our engagement in the healthcare process.

Discussed topics included how to incentivize “value before volume,” building communication between radiologists and patients, the importance of a patient-centered system, readability of reports as essential to improving communication, increasing collaboration with other physicians to improve patient experience, utilization management and standardized guidelines, and considerations in transitioning to Imaging 3.0.

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Imaging-Detected Incidental Thyroid Nodules that Undergo Surgery: A Single-Center Experience Over 1 Year

Fellows’ Journal Club November 2014

(3 of 3)

The authors describe the imaging and pathology results of 47 patients who underwent surgery for incidentally found thyroid nodules. All patients had biopsies before surgery but only 4% of these showed benign processes. Surgery eventually demonstrated that 51% of nodules were benign and when malignant the most common histology was papillary type.

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Abstract

BACKGROUND AND PURPOSE
Incidental thyroid nodules are commonly seen on imaging, and their work-up can ultimately lead to surgery. We describe characteristics and pathology results of imaging-detected incidental thyroid nodules that underwent surgery.

MATERIALS AND METHODS
A retrospective review

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Risk Factors for Early Hemorrhagic Complications after Endovascular Coiling of Ruptured Intracranial Aneurysms

Fellows’ Journal Club November 2014

(2 of 3)

A review of 93 patients treated with coiling for ruptured aneurysms was done to identify risk factors of early hemorrhagic complications. Risk factors identified included intracerebral hematoma at presentation, procedural thromboembolic complications, postcoiling antiplatelet therapy, and early initiation of coiling.

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Abstract

BACKGROUND AND PURPOSE
The risk factors of early hemorrhagic complications after endovascular coiling are not well-known. We identified the factors affecting early hemorrhagic complications, defined as any expansion or appearance of hemorrhage shown by head CT in the initial 48 hours after coiling.

MATERIALS AND METHODS
We retrospectively reviewed a series

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Safety and Effectiveness of Sacroplasty: A Large Single-Center Experience

Editor’s Choice November 2014

(3 of 3)

The safety and effectiveness of minimally invasive sacroplasty was assessed in 53 patients treated for cancer-related, osteoporotic insufficiency and traumatic fractures. The procedure was judged to be safe and resulted in significant short-term gains in pain relief, increased mobility, and decreased dependence on pain medication.

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Abstract

BACKGROUND AND PURPOSE
Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Current practice guideline recommendations range from analgesia and physical therapy to resection with surgical fixation. We sought to assess the safety and effectiveness of

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Susceptibility-Diffusion Mismatch Predicts Thrombolytic Outcomes: A Retrospective Cohort Study

Fellows’ Journal Club November 2014

(1 of 3)

The benefit of thrombolytic therapy was assessed in 54 patients with a mismatch between infarct core as seen on DWI and penumbra as seen on SWI. Favorable outcomes were significantly higher in patients with DWI-SWI mismatch than in those without it. The accuracy of the DWI-SWI mismatch for predicting good outcome was higher than that for the more traditional DWI-perfusion mismatch.

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Abstract

BACKGROUND AND PURPOSE
Asymmetric hypointensity of cerebral veins on susceptibility-weighted imaging has been shown to indirectly reflect tissue hypoxia after cerebral ischemia. We therefore investigated whether patients with prominent asymmetry

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Cement Salvage of Instrumentation-Associated Vertebral Fractures

Editor’s Choice November 2014

(2 of 3)

The authors describe the treatment of 22 vertebral compression fractures in 11 patients with metastases and prior spinal instrumentation. Pain improved in all patients, only 1 patient needed additional surgery, and there were no vertebral cement augmentation–related complications.

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Abstract

BACKGROUND AND PURPOSE
Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Current practice guideline recommendations range from analgesia and physical therapy to resection with surgical fixation. We sought to assess the safety and effectiveness of sacroplasty, an emerging minimally invasive treatment.

MATERIALS

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Leukoaraiosis Predicts a Poor 90-Day Outcome after Endovascular Stroke Therapy

Editor’s Choice November 2014

(1 of 3)

The authors explored the relationship between white matter changes and outcome in 129 patients who received endovascular therapy for acute stroke. Severe white matter changes were associated with poor outcomes at 90 days. Those who survived and had pre-existing severe white matter changes also showed significantly less improvement.

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Abstract

BACKGROUND AND PURPOSE
Leukoaraiosis is a common finding among patients with ischemic stroke and has been associated with poor stroke outcomes. Our aim was to ascertain whether the severity of pre-existing leukoaraiosis is associated with outcome in patients with acute ischemic stroke who are

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Endovascular Surgical Neuroradiology: Theory and Clinical Practice

Prestigiacomo CJ. Endovascular Surgical Neuroradiology: Theory and Clinical Practice. Thieme; 2014; 773 pp; 546 ill; $279.99

endo-surg-neurorad-prestigiacomoOstensibly written for neurointerventionalists, this 773-page multi-authored textbook edited by Drs. Charles Prestigiacomo, E. Jesus Duffis, and Cherag Gandhi should have great appeal to all neuroradiologists, whether they are primarily involved with neurointervention or neurodiagnosis. With the ever increasing endovascular approach to vascular-related abnormalities of the brain, head and neck, and spine, or the high volume of interventions being performed for spine abnormalities, the diagnostic neuroradiologist should have appreciation of what is done for certain lesions and what postprocedural images reveal.

Within eleven sections … Continue reading >>

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December AJNR Tweet Chat – Imaging 3.0

Many of you are by now familiar with Imaging 3.0, the vision of the American College of Radiology to strengthen the future of our specialty. The Imaging 3.0 initiative is built upon several pillars: an integrated service environment, leadership in new health care organizations such as accountable care organizations (ACOs), patient-focused care, and a network of tools and services that support the ACR’s goal of positioning radiologists as expert consultants not only to referring physicians but also to the newly emerging health systems.

The concept of an integrated service environment entails appropriateness of imaging, quality assurance and improvement, patient and … Continue reading >>

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Annotated Bibliography, December 2014

1. Grabowski MM, Recinos PF, Nowacki AS, et al. Residual tumor volume versus extent of resection: predictors of survival after surgery for glioblastoma. J Neurosurg. 2014; November:1–9. doi:10.3171/2014.7.JNS132449.

The utility of maximal tumor resection in glioblastoma continues to be controversial. The authors performed a retrospective review of 128 patients who underwent primary resection of supratentorial GBM followed by standard radiation/chemotherapy and undertook a quantitative, volumetric analysis of pre- and postoperative MR images. Contrast enhancing residual tumor volume and extent of resection were found to be significant predictors of survival after resection. Residual tumor volume appears to be an even … Continue reading >>

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