Mapping the cancer imaging research landscape:which cancers are more and which cancers are less frequently investigated?

Objective: To investigate the proportion of published imaging studies relative to incidence and mortality rate per cancer type. Methods: From a random sample of 2500 articles published in 2019 by the top 25 imaging-related journals, we included cancer imaging studies. The publication-to-incidence and publication-to-mortality ratios (defined as the publication rate divided by the proportional incidence and mortality rate, respectively) were calculated per cancer type. Ratios >1 indicate a higher publication rate compared to the relative incidence or mortality rate of a specific cancer. Ratios 2, whereas nonmelanoma of the skin, leukemia, stomach cancer, and laryngeal cancer had publication-to-incidence ratios 2, whereas esophageal cancer, stomach cancer, laryngeal cancer, and leukemia had publication-to-mortality ratio

Maintenance of certification for radiologists:an overview of European countries

Background It is currently unclear whether the continuing medical education (CME) requirements for radiologists to keep up their certification are equal across Europe, which would be desirable for uniform cross-border quality of radiology and because of the fundamental principle of free movement of workers in the European Union. This study aimed to determine the maintenance of certification requirements for radiologists in different European countries. Methods National radiological societies of European countries and/or their delegates as listed on the European Society of Radiology website were contacted to inquire about the maintenance of licensure requirements for radiologists in their country. Data were analysed using descriptive statistics. Results Forty-six European countries were contacted. Response rate was 80%. Twenty-two of 36 responding countries (59%) reported mandatory requirements to maintain a radiologist's license to practise. The median license period was 5 years (range 1-7). The median required number of CME points per year was 40 (range 8-58, interquartile range 30). Eight countries reported additional requirements, including practising clinical radiology, attending quality meeting/clinical audit, and attending additional courses (such as radiation safety training and advanced medical training course). Fifteen of 37 responding countries (41%) did not report mandatory requirements. Conclusions There is considerable heterogeneity across European countries regarding the maintenance of certification requirements for radiologists. More homogeneity is desired for uniform quality assurance and professional mobility of radiologists across Europe. The data from our overview may be used to establish a benchmark for national societies who issue maintenance of licensure requirements for radiologists

Dynamic susceptibility MR perfusion in diagnosing recurrent brain metastases after radiotherapy:A systematic review and meta-analysis

Background: The diagnostic performance of dynamic susceptibility contrast (DSC) MR perfusion in discriminating treatment-related changes from recurrence in irradiated brain metastases is currently not completely clear. Purpose: To systematically review the accuracy of DSC MR perfusion in diagnosing recurrent brain metastases after radiotherapy. Study Type: Systematic review and meta-analysis. Subjects: MEDLINE and Embase were searched for original studies investigating the accuracy of DSC MR perfusion in diagnosing recurrent brain metastases after radiotherapy. Ten studies, comprising a total of more than 271 metastases, were included. Field Strength/Sequence: 1.5T or 3.0T, DSC MR perfusion. Assessment: Quality assessment was performed according to the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Statistical Tests: Sensitivity and specificity were pooled with a bivariate random-effects model. Heterogeneity was assessed by a chi-squared test. Potential sources for heterogeneity were explored by subgroup analyses. Results: In seven studies the diagnostic criterion was not prespecified. In eight studies it was unclear whether the reference standard was interpreted blindly. In seven studies it was unclear whether DSC MR perfusion results influenced which reference standard was used. Pooled sensitivity and specificity were 81.6% (95% confidence interval [CI]: 70.6%, 89.1%) and 80.6% (95% CI: 64.2%, 90.6%), respectively. There was significant heterogeneity in both sensitivity (P = 0.005) and specificity (P 0.2). Due to insufficiently detailed reporting, it was not possible to investigate the influence of primary tumor origin on accuracy. Data Conclusion: Our results suggest that the accuracy of DSC MR perfusion in diagnosing recurrent brain metastases after radiotherapy is fairly high. However, these findings should be interpreted with caution because of methodological quality concerns and heterogeneity between studies. Level of Evidence: 3. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2020;51:524–534

Diagnostic performance of MRI in detecting residual soft tissue sarcoma after unplanned excision:Systematic review and meta-analysis

Objective: To investigate, in a systematic review and meta-analysis, the diagnostic performance of MRI in detecting residual disease after unplanned excision of soft tissue sarcoma. Methods: Medline and Embase were searched for original studies on the diagnostic performance of MRI detecting residual soft tissue sarcoma after unplanned excision. Study quality was assessed using QUADAS-2. Sensitivity and specificity were pooled using a bivariate random-effects model. A Chi-squared test was used to test for heterogeneity. Results: Ten studies were included, comprising a total of 469 patients. Median frequency of residual soft tissue sarcoma was 54.6% (range 31.6–73.1%). There was high risk of bias with respect to flow and timing in one study. There were applicability concerns with respect to patient selection in four studies. Nine studies reported to use the presence of a mass as a diagnostic criterion for residual soft tissue sarcoma. Sensitivities of included studies ranged between 36.4% and 86.7%, and specificities ranged between 77.8% and 100%. Pooled sensitivity was 65.9% (95% confidence interval [CI]: 55.5–74.9%) and pooled specificity was 85.1% (95% CI: 79.1–89.6%). The area under the summary receiver operating characteristic curve was 0.852. The included studies were statistically heterogeneous in their estimates of sensitivity (P = 0.016) and statistically homogeneous in their estimates of specificity (P = 0.793). Conclusion: The presence of a mass is the most commonly reported diagnostic criterion to diagnose residual soft tissue sarcoma after unplanned resection. MRI achieves moderate sensitivity and fairly high specificity. Pooled estimate of sensitivity was subject to heterogeneity, which needs further exploration

Imaging of facet joint diseases

Facet joints are the important articular pillars of the spine. Several pathologies can occur in and around the facet joint, including extra ossicles, traumatic dislocation, osteoarthritis, synovial cyst, axial spondyloarthritis, rheumatoid arthritis, calcium pyrophosphate deposition disease, septic arthritis, and malignant and benign neoplasms. Imaging is the mainstay to detect and characterize these diseases. In this review, we discuss the anatomy and function of facet joints, imaging techniques, and the imaging findings of several facet joint diseases. This information may be helpful to radiologists to make the correct diagnosis and optimize the management of patients with facet joint diseases

Diagnostic performance of MRI and CT in diagnosing necrotizing soft tissue infection:a systematic review

Objective To systematically review the accuracy of MRI and CT in diagnosing necrotizing soft tissue infection (NSTI). Methods MEDLINE and Embase were searched for original studies which reported the diagnostic performance of MRI or CT in detecting NSTI. Individual study quality was assessed using the QUADAS-2 tool. Sensitivity and specificity of MRI and CT were calculated and, if supported by data from at least two studies, pooled using a bivariate random-effects model. Results Six MRI studies and 7 CT studies were included. There were no major concerns with regard to study quality and applicability. The included studies used multiple diagnostic criteria, with sensitivities and specificities of both MRI and CT ranging between 0 and 100%. T2 hyperintensity of deep fascia was the most commonly used diagnostic MRI criterion (5 studies), yielding a pooled sensitivity of 86.4% (95% confidence interval [CI] 76.1-92.7%) and a pooled specificity of 65.2% (95% CI 35.4-86.6%). Presence of gas was the most commonly used diagnostic CT criterion (3 studies), yielding a pooled sensitivity of 48.6% (95% CI 37.1-60.2%) and a pooled specificity of 93.2% (95% CI 73.3-98.5%). Conclusion T2 hyperintensity of deep fascia at MRI has high sensitivity and moderate specificity in diagnosing NSTI. Presence of gas at CT has low sensitivity but high specificity. A combination of diagnostic criteria may improve diagnostic performance, but this needs further investigation

Medical disciplinary jurisprudence in alleged malpractice in radiology:10-year Dutch experience

Purpose To systematically investigate the frequency and types of allegations related to radiology practice handled by the Dutch Medical Disciplinary Court in the past 10 years. Methods The Dutch Medical Disciplinary Court database was searched for verdicts concerning radiology practice between 2010 and 2019. The association between the number of verdicts and time (years) was assessed by Spearman's rho. Other data were summarized using descriptive statistics. Results There were 48 verdicts (mean 4.8 per year). There was no significant association between the number of verdicts and time (Spearman's rho <0.001, p = 0.99). Most allegations were in breast imaging and musculoskeletal radiology (each 18.8%), followed by interventional radiology, head and neck imaging, and abdominal imaging (each 12.5%), neuroradiology and vascular imaging (each 10.4%), and chest imaging (4.2%). There were 46 allegations against radiologists (95.8%) and 2 against residents (4.2%). The most common allegation (37.5%) was error in diagnosis. In 20.8% of verdicts, the allegation was judged (partially) founded; disciplinary measures were warnings (n = 8) and reprimands (n = 2). An appeal was submitted by the patient in 11 cases and by the radiologist in 3 cases. All appeals by patients were rejected, whereas 2 of the 3 appeals by radiologists were granted and previously imposed disciplinary measures were reversed. Conclusion Allegations against radiologists at the Dutch Medical Disciplinary Court are relatively few, their number has remained stable over the past 10 years, and a minority were judged to be (partially) founded. We can learn from the cases presented in this article, which may improve patient care

Workload of diagnostic radiologists in the foreseeable future based on recent scientific advances:growth expectations and role of artificial intelligence

OBJECTIVE: To determine the anticipated contribution of recently published medical imaging literature, including artificial intelligence (AI), on the workload of diagnostic radiologists. METHODS: This study included a random sample of 440 medical imaging studies published in 2019. The direct contribution of each study to patient care and its effect on the workload of diagnostic radiologists (i.e., number of examinations performed per time unit) was assessed. Separate analyses were done for an academic tertiary care center and a non-academic general teaching hospital. RESULTS: In the academic tertiary care center setting, 65.0% (286/440) of studies could directly contribute to patient care, of which 48.3% (138/286) would increase workload, 46.2% (132/286) would not change workload, 4.5% (13/286) would decrease workload, and 1.0% (3/286) had an unclear effect on workload. In the non-academic general teaching hospital setting, 63.0% (277/240) of studies could directly contribute to patient care, of which 48.7% (135/277) would increase workload, 46.2% (128/277) would not change workload, 4.3% (12/277) would decrease workload, and 0.7% (2/277) had an unclear effect on workload. Studies with AI as primary research area were significantly associated with an increased workload (p < 0.001), with an odds ratio (OR) of 10.64 (95% confidence interval (CI) 3.25–34.80) in the academic tertiary care center setting and an OR of 10.45 (95% CI 3.19–34.21) in the non-academic general teaching hospital setting. CONCLUSIONS: Recently published medical imaging studies often add value to radiological patient care. However, they likely increase the overall workload of diagnostic radiologists, and this particularly applies to AI studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13244-021-01031-4