Predictors of pathologic outcome of focal FDG uptake in the parotid gland identified on whole-body FDG PET imaging

PURPOSE: To test whether patient's primary malignancy type and presence of FDG-avid cervical lymph node(s) are predictors of pathologic outcome of incidental focal FDG-avid parotid lesions. BASIC PROCEDURES: Retrospective cohort study of pathologically proven incidental cases. MAIN FINDINGS: Focal parotid FDG uptake in the setting of head and neck cancer/melanoma(OR=24.6,p<0.01), lymphoma(OR=7.2,p=0.02), or FDG-avid cervical lymph node(s)(OR=3.6,p=0.07) has a higher odds of representing metastases. No malignant primary parotid tumors were incidentally discovered. PRINCIPAL CONCLUSIONS: In patients with head and neck cancer/melanoma, lymphoma, or FDG-avid cervical lymph node(s) there was a higher odds that focal parotid FDG uptake was a metastasis

Critical Changes in the Staging of Head and Neck Cancer

The many changes made to the head and neck (HN) chapters of the eighth edition of the American Joint Committee on Cancer (AJCC) and Union for International Cancer Control (UICC) cancer staging manuals have resulted in confusion from clinicians and radiologists. These changes have even raised concerns for validity. In prior staging manual updates, the changes made largely provided simplification of more complex staging details. The current eighth edition of the AJCC/UICC staging manuals introduced greater granularity to HN tumor staging. This reflects the current understanding of pathophysiology of these cancers and is necessary to create a more accurate prognosis for these patients. The most commonly encountered example of manual changes is the separate staging of viral-associated oropharyngeal squamous cell carcinoma from tobacco and alcohol use-associated squamous cell carcinoma. While anatomic imaging is critical for HN cancer staging, and frequently outweighs clinical examination, some changes to staging make it impossible for a stage to be assigned until surgical resection is performed. In all, the AJCC/UICC eighth edition changes, the impact on radiologists, and the rationale behind the changes will be discussed. Additionally, opportunities for radiologists to contribute to research that may influence the next edition of AJCC/UICC cancer staging manuals will be proposed. Keywords: Head/Neck, Oncology, Pharynx, Staging © RSNA, 2020

Maximizing Current Neuro-Imaging: Tricks and Traps (.pdf)

"The advent of MRI in the 1980s transformed the world of diagnostic imaging with a better ability to localize neurological disease and an unprecedented ability to differentiate disease processes. Previously, the only non-invasive imaging of neurological disease was with plain radiographs and CT, which at that time was a single detector scanner with significantly longer scan times and with poor spatial resolution. X-rays and CT were supplemented with catheter neuroangiography which prior to the development of CT had been used to localize lesions by demonstrating mass effect through displacement of vessels. There have been many important developments in the field of MR imaging since the 1980's, both in MR equipment and in scanning techniques, making those earliest scans seem of very poor quality by comparison."GVSgeneralimaging; Medical Knowledge; Patient Care; Practice Based Learning and Improvement; Systems Based Practice; EXAMmri; EXAMctahead; EXAMmrahead; EXAMmr

Maximizing Current Neuro-Imaging: Tricks and Traps (video)

"The advent of MRI in the 1980s transformed the world of diagnostic imaging with a better ability to localize neurological disease and an unprecedented ability to differentiate disease processes. Previously, the only non-invasive imaging of neurological disease was with plain radiographs and CT, which at that time was a single detector scanner with significantly longer scan times and with poor spatial resolution. X-rays and CT were supplemented with catheter neuroangiography which prior to the development of CT had been used to localize lesions by demonstrating mass effect through displacement of vessels. There have been many important developments in the field of MR imaging since the 1980's, both in MR equipment and in scanning techniques, making those earliest scans seem of very poor quality by comparison."GVSgeneralimaging; Medical Knowledge; Patient Care; Practice Based Learning and Improvement; Systems Based Practice; EXAMmri; EXAMctahead; EXAMmrahead; EXAMmr

Maximizing Current Neuro-Imaging: Tricks and Traps (slideshow)

"The advent of MRI in the 1980s transformed the world of diagnostic imaging with a better ability to localize neurological disease and an unprecedented ability to differentiate disease processes. Previously, the only non-invasive imaging of neurological disease was with plain radiographs and CT, which at that time was a single detector scanner with significantly longer scan times and with poor spatial resolution. X-rays and CT were supplemented with catheter neuroangiography which prior to the development of CT had been used to localize lesions by demonstrating mass effect through displacement of vessels. There have been many important developments in the field of MR imaging since the 1980's, both in MR equipment and in scanning techniques, making those earliest scans seem of very poor quality by comparison."GVSgeneralimaging; Medical Knowledge; Patient Care; Practice Based Learning and Improvement; Systems Based Practice; EXAMmri; EXAMctahead; EXAMmrahead; EXAMmr

Bias in Radiology: The How and Why of Misses and Misinterpretations.

Medical errors are a leading cause of morbidity and mortality in the medical field and are substantial contributors to medical costs. Radiologists play an integral role in the diagnosis and care of patients and, given that those in this field interpret millions of examinations annually, may therefore contribute to diagnostic errors. Errors can be categorized as a "miss" when a primary or critical finding is not observed or as a "misinterpretation" when errors in interpretation lead to an incorrect diagnosis. In this article, the authors describe the cognitive causes of such errors in diagnostic medicine, specifically in radiology. Recognizing the cognitive processes that radiologists use while interpreting images should improve one's awareness of the inherent biases that can impact decision making. The authors review the common biases that impact clinical decisions, as well as strategies to counteract or minimize the potential for misdiagnosis. System-level processes that can be implemented to minimize cognitive errors are reviewed, as well as ways to implement personal changes to minimize cognitive errors in daily practice. ©RSNA, 2017