Complications of Mesh Sacrocolpopexy and Rectopexy: Imaging Review

Radiologists can help diagnose complications from sacrocolpopexy and rectopexy, two common surgical treatments for pelvic organ and rectal prolapse. CT and MRI are used to evaluate acute and chronic complications, respectively. This article reviews the surgical techniques, imaging protocols, and normal and common complications of these procedures. Get ready to brush up on your knowledge!

Imaging the Cerebral Veins in Pediatric Patients: Beyond Dural Venous Sinus Thrombosis

Pediatric patients can suffer from a variety of cerebral venous diseases, from malformations to thrombosis. This article discusses the practical embryology, anatomy, and imaging modalities used to diagnose these conditions. It also reviews a broad range of congenital and acquired venous diseases, with a focus on less common entities. Imaging is key to diagnosing these conditions, so radiologists must be aware of the various modalities available.

How We Got Here: The Legacy of Anti-Black Discrimination in Radiology

Despite the progress made in the field of radiology, disparities in access to diagnostic imaging for Black patients and the underrepresentation of Black physicians remain. This is due to the institutional racism that was present in the early 20th century when radiology was being developed. Despite this, there were pioneering Black radiologists who advanced the field. Today, there are still structural barriers that negatively impact marginalized groups. To address this, education on disparities in access to imaging and health care among Black patients should be expanded, and antibias methodology should be applied in artificial intelligence algorithms. These strategies may help to reduce health care disparities in radiology.

Multimodality Imaging Review of HER2-positive Breast Cancer and Response to Neoadjuvant Chemotherapy

HER2-positive breast cancer is a type of breast cancer that affects 15-20% of all cases. It is often characterized by an irregular mass with spiculated margins and calcifications. It is of intermediate to high nuclear grade and has a higher risk of recurrence and metastases. However, treatments such as trastuzumab and pertuzumab have improved survival outcomes. Radiologists play an important role in assessing the extent of local-regional disease and response to neoadjuvant treatment. Assessing treatment response is difficult, as different imaging modalities can lead to underestimation or overestimation of disease. Breast MRI is the best predictor of pathologic response. This article reviews the initial manifestations, varied responses to neoadjuvant chemotherapy, and challenges in assessing residual cancer burden.

US for Evaluation of Acute Abdominal Conditions in Neonates

Bedside US is a useful and promising imaging modality for evaluation of acute abdominal conditions in neonates. It can help, complement, and sometimes replace radiographic or contrast-enhanced studies. POCUS can be used to assess and monitor conditions such as necrotizing enterocolitis, malrotation, segmental volvulus, meconium peritonitis, and complicated inguinal hernia. High-resolution US with 15-MHz and higher-frequency probes allows for detailed characterization of the bowel anatomy and features of intestinal abnormalities. Color Doppler US and microvascular imaging can improve accuracy in the detection and characterization of bowel vascularity.

Imaging Care for Transgender and Gender Diverse Patients: Best Practices and Recommendations

Radiology has the opportunity to improve care for transgender and gender diverse (TGD) patients. This includes using appropriate names, pronouns, and gender identity in ordering and scheduling exams, creating a welcoming environment, and using trauma-informed and patient-centered care during image acquisition. Radiologists should also be aware of reporting considerations, such as avoiding gender in reports when not medically relevant and using precise, respectful language for findings related to gender-affirming hormone therapy and surgery. Best practices for inclusive imaging care are summarized.

Benign Bone Tumors: State of the Art in Minimally Invasive Percutaneous Interventions

Bone tumors can be painful and affect the quality of life of pediatric patients and young adults. Recent advances in minimally invasive image-guided interventions have made it possible to treat these tumors with curative intent. Interventional radiologists now have a wide range of treatments available, including thermal ablation, chemical ablation, cementoplasty, and intralesional injections. These treatments are safe, effective, and durable, making them a great option for treating benign bone tumors.

Quality Improvement Report: Improving Pre- and Postprocedure Care Area Workflows at a Busy Urban Academic Hospital Using Lean Management Principles

Radiology procedure workflow can be complex and inefficient. At one institution, a cross-functional team used "lean" process improvement tools to identify and address gaps in the pre- and postprocedure care area (PPCA) workflow. Three projects were implemented over 4 months, resulting in a significant improvement in patient preparation time. Lean management strategies, such as daily management systems and huddles, help to create efficient systems and teams that sustain and improve complex workflows.

Artifacts and Technical Considerations at Contrast-enhanced US

CEUS is a radiologic modality that can be subject to image artifacts, which can negatively impact diagnostic accuracy. These artifacts can be related to gray-scale US or exclusive to CEUS, such as nonlinear artifacts and unintentional microbubble destruction. The authors review the principles of UCAs, technical aspects of image generation, and specific artifacts, with tips on how to identify and mitigate them.

Multidisciplinary Approach to Chronic Thromboembolic Pulmonary Hypertension: Role of Radiologists

Chronic thromboembolic pulmonary hypertension (CTEPH) is a serious condition that requires a multidisciplinary team to determine the best management. Radiologists play an important role in confirming the diagnosis and assessing the extent of the disease. Imaging modalities such as V/Q scanning, echocardiography, CTPA, and right heart catheterization are used to preoperatively assess CTEPH. However, CTEPH can be misdiagnosed due to technical, patient, and radiologist-related factors. PTE is the definitive therapy for CTEPH, but other minimally invasive or noninvasive therapies can also lead to clinical improvements. Postoperative imaging can help identify complications of PTE.

Periosteal Pathologic Conditions: Imaging Findings and Pathophysiology

The periosteum is a key player in bone health and is the skeleton's response to various insults. This article reviews the histology, development, and distribution of normal periosteum, as well as nonaggressive and aggressive types of periosteal reaction. Image-guided biopsies can help determine the cause of the reaction, which can range from benign to malignant. Knowing the distribution of the reaction can help narrow down the cause, with diffuse reactions often being systemic and localized reactions being more localized.

Cone-Beam CT With Enhanced Needle Guidance and Augmented Fluoroscopy Overlay: Applications in Interventional Radiology

CBCT with advanced imaging applications has revolutionized interventional radiology over the past decade, allowing for a broad range of minimally invasive procedures. Benefits include greater accuracy, improved targeting, enhanced visualization, and reduced radiation doses. This article describes the practical implementation of CBCT with enhanced needle guidance and augmented fluoroscopy overlay, and its application for a variety of procedures.

Imaging Artificial Intelligence: A Framework for Radiologists to Address Health Equity, From the AJR Special Series on DEI

AI has the potential to revolutionize healthcare, and radiology is at the forefront of this technology. This article discusses the potential benefits and pitfalls of AI in radiology, with a focus on health equity. We explore ways to reduce disparities and create better healthcare for all, using a practical framework to help radiologists address health equity when implementing new tools.

Reticulation Sign on Thin-Section CT: Utility for Predicting Invasiveness of Pure Ground-Glass Nodules

This study evaluated the use of the reticulation sign on thin-section CT images to predict the invasiveness of pure ground-glass nodules. 876 pGGNs from 795 patients were assessed for a range of features, including the reticulation sign. Results showed that the reticulation sign had high specificity (100%) for an IAC diagnosis, but low sensitivity (24%). It was also an independent predictor of IAC. These findings suggest that pGGNs with the reticulation sign should be strongly suspected to represent IAC.