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ABSTRACT |
Udayasankar U. K.1; Kalra M. K.2; Small W. C.1 1. Emory University School of Medicine, Atlanta, GA; 2. Massachusetts General Hospital, Boston, MA
Address correspondence to U. Udayasankar (uudayas{at}emory.org)
Background: Evidence-based medicine is a clear, meticulous and well-judged use of best current evidence in making decisions about the care of individual patients. The principles of evidence-based medicine could be implemented in radiology by incorporating individual clinical expertise with the best available external research data. Traditionally, randomized clinical trials and meta-analyses were exclusively used as "evidence."
Key Issues: Many revolutionary imaging techniques and interventional procedures have been introduced in recent years. This explosion of technology has made it impossible to collect all the data required to deliver high quality patient care. Lack of a uniform method of critical appraisal of published scientific material adds to the problem. Therefore a review of evidence based radiology would be useful to radiologists in any stage of their training or career.
Format: This will be an interactive educational exhibit elaborating the elements of evidence based radiology and will discuss its applications in the practice of radiology. A simple stepwise approach for employing the methods of evidence-based medicine in radiology will be provided with emphasis on the use of Internet and modern informatics. The role of evidence-based medicine in radiology practice, education and research will be highlighted.
Teaching Points: Appropriate use of principle of evidence-based medicine in radiology will help in improving radiology practice and research. Major teaching points of this exhibit are: 1.To describe the basic principles of evidence-based medicine. 2. To suggest a simple, stepwise approach of adapting these principles in routine diagnostic and interventional radiology. 3. To describe the various methods useful in accessing the available external data and to critically evaluate the data for validity. 4. To describe the use of evidence based radiology in standardizing the analysis and reporting of radiological studies.
E096. Competency-Based Education in Radiology Residency Training: Implementation, Evaluation and Outcomes Assessment
Suri R.; Dalrymple N.; Garcia G.; Clarke E. A. University of Texas Health Sciences Center at San Antonio, San Antonio, TX
Address correspondence to R. Suri (suri{at}uthscsa.edu)
Background: Traditionally, training in medical specialties has concentrated on medical knowledge and patient care. Standardized methods were accordingly developed to evaluate the achievement of these goals to assess the performance of the student and the effectiveness of the training program. However, other tangible measures of performance were never considered in this traditional method. Hence, in 1999, the ACGME changed requirements for training and evaluation and identified six core competencies as an essential requisite for competency-based education, the implementation of which was assigned to individual Residency Review Committees.
Key Issues: The premise of competency-based education is a step-wise advancement through the training program upon demonstration of the trainee's competence against measurable goals and objectives for each level of training. The trainee's competence is evaluated for each of the identified six core competencies separately, with the ultimate aim being competency in all areas. The core competencies identified by ACGME are–patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and systems based practice. For successful implementation of these core competencies, educational methodologies need to be tailored to the individual competencies and to the trainee, to promote individual self assessment.
Format: This educational exhibit shall define the six identified core competencies and portray how our training program integrated these core competencies into our educational curriculum. The portfolio evaluation approach that we implemented to foster self-assessment by our trainees shall be highlighted. Measurable goals and objectives that were identified in our program for the individual competencies for individual levels of training shall be described. Educator-trainee 180-degree evaluation forms and locally created 360-degree evaluation forms shall be portrayed along with other tools as a method for individual evaluation. Approaches for outcomes assessment shall be discussed in an interactive/quiz format to foster viewer participation, and to identify more options in this rapidly evolving arena of educational assessment.
Teaching Points: 1. Define the six core competencies identified by ACGME and highlight the relevant current literature. 2. Describe our program's comprehensive approach to fulfilling the ACGME requirements for implementation of competency based education, measurement and evaluation
E097. Tips of the Trade: Not for First Years Only!
Chandrasekhar C. The University of Texas Medical School at Houston, Houston, TX
Address correspondence to C. Chandrasekhar (Chitra.Chandrasekhar{at}uth.tmc.edu)
Background: Taking imaging call as a first-year radiology resident is not always easy. As a part of resident training, an introductory "fundamentals" or core curriculum course is given during the first half of the freshman year in many residency programs. These courses cover the bare essentials of radiology. Sufficient "eye training" may not be fully achieved by all residents in spite of the course offered.
Key Issues: A succinct yet comprehensive nutshell of "tips of the trade" is presented to help make body imaging call easier; with common pitfalls to avoid in the interpretation of body CTs. A didactic form of presentation with typical case scenarios based on organ systems for abdominal imaging will be included.
Format: A didactic format will be used.
Teaching Points: 1.To provide an effective, comprehensive and quick "call reference guide" for nontraumatic body imaging call. 2. Review "on call" typical "aunt minnies" to prepare the first-year novice for taking call. 3. To enumerate often used measurements and descriptive terminologies to provide a quick reference guide.
E098. Critical Calls on Call: A Guide for First-Year Residents Assuming Call Responsibilities
Yellin J.1; Delbridge C.1; Massrour K.1; Richardson R.2; Switzer M.1 1. Maricopa Medical Center, Phoenix, AZ; 2. St. Joseph's Hospital and Medical Center, Phoenix, AZ
Address correspondence to J. Yellin (joshuayellin{at}yahoo.com)
Background: Academic radiology training programs in the United States typically train first year residents for six months before exposing them to an "on call" environment. While the level of autonomy varies greatly among different institutions, the level of anxiety experienced by the fledgling radiologists does not. Even with sufficient knowledge, lack of experience and/or confidence can contribute to overestimation of benign findings and, more concerning, underestimation of critical findings associated with catastrophic consequences in the event of diagnostic delay. We have put together an interactive computer exhibit directed at first year residents preparing for call. The exhibit covers benign findings commonly encountered on call that may cause undue concern and critical pathology that absolutely should not be missed. It is not intended to be a comprehensive review of emergency radiology but rather a measuring stick to gauge preparedness for call responsibilities.
Key Issues: Our presentation is limited to the eight most commonly ordered diagnostic imaging studies from the hours of 5:00 pm to 7:00 am and encompasses the modalities a resident is most likely to encounter on call.
Format: The presentation is organized by study type rather than organ system. Studies commonly encountered on call are addressed and are divided into plain film (c-spine, chest, abdomen/pelvis) and CT (head, c-spine, thorax, abdomen, pelvis). Each finding will be addressed systematically in the following fashion:-Diagnosis or differential diagnosis. -Urgency/Acuity. -Additional imaging required or recommended.
Teaching Points: Our exhibit is intended to help prepare radiology residents with limited experience for what they will encounter on call. Specifically, we will focus on findings associated with catastrophic results if not quickly and accurately identified by the consulting radiologist. Teaching points include: -How to confidently identify findings associated with critical diagnoses that must not be missed in the acute setting. -Appropriate recommendations for additional imaging if a diagnosis is in question or to evaluate for associated pathology. -How to minimize or avoid imaging that confers no significant patient benefit in the acute setting. -How to minimize or avoid common mistakes related to resident inexperience.
E099. The Hardest Thing to See Is What Isn't There
McAdory L.; Kreeger M.; Oostveen R.; Wissman R.; Leach J. University of Cincinnati, Cincinnati, OH
Address correspondence to L. McAdory (mcadoryl{at}yahoo.com)
Background: Radiologic diagnosis is often made on the basis of positive findings which are direct manifestations of disease. An example would be an air space opacity in the lung which may represent pneumonia. On the other hand, many disease processes are recognized or suspected by the absence of a normal structure or anatomic relationship. An obvious example would be agenesis of the corpus callosum. A more subtle example would be the absence of a vertebral pedicle due to metastatic disease. In some cases, such negative findings may be the only key to making the correct diagnosis.
Key Issues: The proposed exhibit will emphasize the importance of recognizing the absence or attenuation of normal anatomic structures and relationships in the diagnosis of pathology. Sample cases with such negative findings will be presented in various imaging modalities. In some cases, recognizing the negative finding will lead directly to a diagnosis. In other cases, the negative finding will be an indirect sign of an otherwise occult abnormality. In these cases, an additional study will be required to confirm the diagnosis.
Format: The exhibit will be presented in quiz format. A series of unknown cases will be presented. Participants will be prompted to identify the missing or diminished anatomic structure or relationship. Subsequently, participants will be asked to make the diagnosis or request an additional test to reveal the suspected diagnosis. Each case will be followed by a discussion of the negative imaging findings and how they lead to the diagnosis.
Teaching Points: The viewer will learn to recognize missing or diminished normal anatomic structures and relationships. The viewer will further learn how these negative findings can lead to the diagnosis of disease.
E100. The Physics of Clinical 3.0-T MR Taught Through Images
Runge V.2; Stieltjes B.3; Nitz W. R.4; Schmeets S.5; Schoenberg S. O.1 1. Department of Clinical Radiology, University of Munich-Grosshadern Campus, Muenchen, Germany; 2. Department of Radiology, Scott & White Clinic, Temple, TX; 3. German Cancer Research Center, Heidelberg, Germany; 4. Siemens Medical Solutions, Erlangen, Germany; 5. Siemens Medical Solutions USA, Inc., Malvern, PA
Address correspondence to V. Runge (runge{at}att.net)
Background: 3.0 T offers, compared to 1.5 T, improved spatial resolution and/or reduced scan time, due to greater SNR. This exhibit highlights the distinguishing properties of 3.0 T in clinical MR including the benefits of dedicated multichannel coils, the role of parallel imaging, optimizing pulse sequences, contrast enhancement, and managing SAR limits.
Key Issues: 3.0 T offers today a major advance in clinical imaging of the brain, head and neck, cervical spine, heart, CE-MRA, musculoskeletal system, and prostate. Comparative studies performed on side by side 1.5- and 3.0-T MR units in a clinic setting are used to illustrate advances and limitations. Methods for reducing SAR, a critical issue, are discussed including the use of low flip angles, low SAR pulses, variable flip angles (hyperechoes, SPACE), gradient echo imaging and the use of parallel imaging.
Format: The exhibit format is didactic. The data is structured by imaging technique, with examples of the effects of different imaging strategies shown using clinical examples.
Teaching Points: Improvements at 3.0 T come from greater SNR, made accessible by technologic developments. The adaptations in terms of pulse sequence design that must be made to provide images with superior diagnostic quality have been substantial and are ongoing. Examples are numerous, including for instance the ability to obtain high quality T1-weighted images in the brain and cervical spine, made possible–despite SAR limitations and T1 prolongation–by a different solution in each anatomic area.
E101. Role of Screening CT in Early Detection of Diseases: Risks versus Benefits
Udayasankar U. K.; Sebastian S.; Small W. C. Emory University School of Medicine, Atlanta, GA
Address correspondence to U. Udayasankar (uudayas{at}emory.org)
Background: Computed tomography (CT) screening techniques have been advocated as a means to potentially reduce mortality, especially in patients with cancers. Beyond the potential for avoiding death, screening CT may reduce morbidity since treatment for earlier-stage diseases is often less aggressive than that for more advanced cases. CT allows detection of more early-stage cancers that are smaller in size than those detected with radiography and in current clinical practice.
Key Issues: Routine CT screening is being performed for detection of certain oncological and nononcological diseases. Recently, whole-body CT screening has been introduced, and it is being marketed as a preventive or proactive healthcare measure to healthy individuals. Compared to the routine radiographic screening techniques, screening CT studies are usually associated with a higher radiation dose. There is also the fear of raising healthcare costs with the rising number of CT investigations. Balancing the benefits of screening CT with potential harmful effects is the key.
Format: This exhibit will be in the form of a didactic lecture elaborating screening CT techniques for different oncological and nononcological indications. The potential benefits and harmful effects of individual CT technique will be discussed. The data will be shown in the form of charts, tables and CT images. Following CT screening studies will be discussed in detail. 1. Whole-body CT screening. 2. CT lung cancer screening. 3. Screening CT colonography. 4.Screening CT for coronary artery disease.
Teaching Points: Advances in multidetector row CT technology that help in reducing radiation dose without compromising image quality in CT screening studies including bow-tie filters, automatic tube current modulation technique, low tube voltage and dual energy scanners will be described. The major teaching point of this exhibit is to highlight the techniques of various screening CT studies and help the reader to critically appraise the studies balancing the benefits with the risks.
E102. The Impact of Apology and Apology Laws on Radiology Practice
Baker S.; Sintim-Damoa A. UMDNJ–New Jersey Medical School, Newark, NJ
Address correspondence to S. Baker (bakersr{at}umdnj.edu)
Background: Recent efforts to improve quality in the delivery of medical care have generated initiatives seeking greater dialogue and accountability between providers and patients. Mandatory reporting of errors and other disclosure protocols are now becoming commonplace. In addition, the role of apology has been promoted both as a means of fostering greater trust and as a maneuver to reduce the likelihood of a malpractice suit after a medical error has occurred. In the past five years, twenty-nine states have passed apology laws to encourage prompt and sincere admission of regret by physicians. The purposes of this discussion are to examine the elements of apology and differentiate it from apologia, or a mere accounting with no admission of wrongdoing, to examine the resemblances and distinctions of the various newly enacted statutes with respect to apology, and to present the risks specific to a radiologist with respect to the conflict an apology may engender with a referring physician when both are party to a claim of a medical error.
Key Issues: No anatomic, physiologic issues, imaging findings, or imaging techniques will be discussed.
Format: The exhibit will be primarily didactic and will be organized based on the different legislation different states have enacted.
Teaching Points: 1. Different laws that protect physicians in court from their apologies to patients. 2. Reasons why radiologists need to be wary of apologizing to patients.
E103. Overcoming Hurdles to Improve CT Workflow–A Reimagination
Singh A. K.2; Sahani D. V.2; Joshi M.1; Ouellette-Depiazzo K.2; Thrall J. H.2 1. GE Healthcare, Belmont, MA; 2. Massachusetts General Hospital, Boston, MA
Address correspondence to A. Singh (dranandsingh{at}yahoo.com)
Background: The purpose of this exhibit is to: 1.Outline the delays in CT workflow that can occur at various levels from entry of patient in the CT department to the dispatch of CT scan reports. 2. Emphasize simple timesaving solutions by ongoing experience and suggest more acceptable and user-friendly options for planning CT scans and postprocessing.
Key Issues: Though newer MDCT scanners provide desired images to radiologists and surgeons the delays in generation of CT reports is becoming a concerning factor. In this exhibit, we discuss the reasons for such delays, which pose increased demand for labor and costly post processing equipment. We also propose possible solutions for avoiding such delays, which can reduce patient waiting time, provide timely availability of postprocessed images to readers and reduce workload on 3D workstations.
Format: This exhibit will be didactic. We discuss the reasons for such delays, which pose increased demand for labor and costly post processing equipments. We also propose possible solutions for avoiding such delays, which can reduce patient waiting time, provide timely availability of postprocessed images to readers and reduce workload on 3D workstations.
Teaching Points: The major teaching points of this exhibit are: 1.Increased scanner occupancy by patients and 3D image post processing time cause delay's in CT workflow and newer tools like direct multiplanar reformats (DMPR) at the newer CT consoles can be a quick image postprocessing option. 2. Developing newer protocol recognition tools for technologists can increase their work efficiency decreasing scanner occupancy time.
E104. The Evolving Role of the Internet as an Educational Resource for Physicians
Johnson P. T.; Rowell M. R.; Scatarige J. C.; Fishman E. K. Johns Hopkins School of Medicine, Baltimore, MD
Address correspondence to P. Johnson (pjohnso5{at}jhmi.edu)
Background: Growth of the World Wide Web has been accompanied by an increase in medical informational resources and utilization by physicians for educational purposes. To determine means of improving the educational resources available, assessment of users' needs is imperative. The purpose of this review is to identify how physicians' perceptions and patterns of Web use have changed over the last decade.
Key Issues: This exhibit reviews published studies from 1996–2006 that surveyed physicians, to determine how their Internet use for medical information retrieval and education has evolved over time. Results from a 2006 survey of 212 radiology professionals posted on our body CT Website will be compared to a previous similar survey from 2001.
Format: Didactic format organized as follows: (1) Introduction. (2) Method of literature search and results. (3) Comparison of survey design across studies. (4) Respondents' demographics. (5) Internet access: prevalence, means, location and frequency. (6) Perceptions: reliability of the information available, comparison with traditional resources, factors that draw users to a Web based resource and limitations of the Internet. (7) Preferences: use of the Web for CME and journal reading, preferred Websites and educational content.
Teaching Points: 1. This review elucidates impediments to Web use for physician education and information retrieval that persist despite technological advancement and increasing user experience. 2. Radiology professionals reported increasing use of the Web for education; however, content preferences have not changed dramatically since 2001.
E105. Creation of a Feature-Rich Radiology Residency Program Website
Kendra J. S.; Mezwa D. William Beaumont Hospital, Royal Oak, MI
Address correspondence to J. Kendra (jeremykendra{at}gmail.com)
Background: The World Wide Web is the standard for which information and ideas are rapidly conveyed and shared amongst individuals and groups. A presence on the Web is a practical way for any practice or department to easily disseminate information to patients, referring physicians and colleagues. But rather than just merely displaying static content, today's interactive Websites afford much more functionality to its users. Connectivity to the Internet is ubiquitous in today's society making availability to such resources nearly effortless. These qualities make the need for a well developed Website essential to any practice, or in our case, radiology residency program. Using widely available and freely distributed programming tools, the authors developed wbhrad.com, a Website that was initially developed as a way to easily share our "Case of the Week" teaching files, but has now grown into a fully featured radiology residency program Website. While there are plenty of content management systems available to produce generic residency Websites, to our knowledge none have been created with features specific to radiology.
Key Issues: Wbhrad.com's "Case of the Week" was developed using a MySQL database with PHP, HTML and Javascript as the primary programming languages. An intuitive user interface allows user to upload their images and case information to the database from anywhere with Internet access. Answers to cases may be scored, and cumulative results for participants are automatically updated. Participation in "Case of the Week" at our institution has tripled since the inception of Internet-based presentations. Additional features to wbhrad.com include secure user login with variable level access, a searchable interesting case database, a personal case database with the ability to mark cases for follow-up, online teaching files creation, message board forums, a procedures log, on call and conference calendars, a powerful and versatile text paging system, user submitted hyperlinks of educational Websites with a peer review rating system, and many more features that are currently in production.
Format: This exhibit is a fully functional online demonstration of our radiology residency program internet solution. Login to wbhrad.com with username: guest, password: guest.
Teaching Points: 1. A fully functional radiology residency web site is a valuable asset that does more than just relay information. 2. Such a Website is not difficult to implement or maintain.
E106. Online Video Lecture Development Using only Open Source Software Programs
Derr D.; Coleman J.; Nutter K. University of Mississippi Medical Center, Jackson, MS
Address correspondence to D. Derr (drd0031{at}yahoo.com)
Background: The Internet has become an important component of medical education. Most of the medical information available has historically been in the form of static pictures, short video clips and written articles. With widespread broadband and cheap digital storage we are now able to distribute full length high resolution lectures. This paradigm shift will now allow professionals across the country in both academic and private practice access to the most current concepts in medicine. We will demonstrate our technique for lecture development using only open source programs which are available for download without cost.
Key Issues: We will identify open source programs freely available for download over the Internet which will allow for digital image manipulation like Adobe Photoshop, presentation preparation like Microsoft PowerPoint, Video editing like Adobe Premier and live lecture capture like TechSmith Camtasia Studio. We will demonstrate the basic functions of each program individually and then combine these skills to generate a video lecture presentation.
Format: This will be a step by step didactic exhibit which will first describe basic features of each program then combine these topics to develop an online presentation.
Teaching Points: 1. Discover open source technology as an alternative to high priced proprietary software. 2. Learn to use the basic functions of each open source software program to quickly and easily produce quality live presentations or streaming Internet lectures.
E107. A w.w.w. Page as a Lifelong-Learning Tool. A Tutorial on How to Design, and Implement It
Esguerra A.; Angarita M.; Pinzón B. Center for Interactive Digital Education in Radiology (CIDER), Fundación Santa Fe de Bogotá, Bogotá, Colombia
Address correspondence to A. Esguerra (alfonso.esguerra{at}cider.edu.co)
Background: The concept of lifelong learning ensures the solid acquisition of knowledge. Because of its image based practice, high resolution formats are essential to the practice, and teaching of radiology. Since high resolution images are characteristic of the Web, and technological innovations permit an easy access to it. Lifelong learning programs available in Intra or Internet loops are today an effective tool in the teaching of radiology. The following is a tutorial on how to design, and implement an interactive Internet Web page as a lifelong learning tool in radiology. The tutorial is based on our experience in the "in-house" design and implementation of a Web page devoted to pulmonary radiology.
Key Issues: The proposed Web page consists of the following sections: • WEB LOG as an integral part of the interactivity of all the sections. • E-BOOK SECTION where interactive atlas-like e-books are available. • TUTORIAL SECTION where interactive short tutorials on various radiological subjects are available. • CASE OF THE MONTH SECTION • RADIOLOGY TEACHING FILE.
Format: The exhibit will address, in an interactive fashion, the design, and implementation of each component of the Web page, as well as the Web page itself.
Teaching Points: The tutorial allows participants to: • Understand the changes needed to transform educational aids into useful lifelong learning tools. • Design, and implement a Web page, and Web log, using a modification of an open source program. • Transform a PowerPoint presentation into an interactive e-textbook, tutorial or case of the month, accessible on the Web. • Design, and implement a radiology teaching file accessible on the Web, using a modification of an open source archival system.
E108. Role of State of the Art Interactive 3D Imaging as a Modern Tool for Anatomic Education of Medical Students: A Posse ad Esse (From Possibility to Actuality)
Sebastian S.; Casarella W.; Turner M.; Peterson K.; Small W. Emory University School of Medicine, Atlanta, GA
Address correspondence to S. Sebastian (Sunit.Sebastian{at}emoryhealthcare.org)
Background: Anatomy is one of the most fundamental of medical school disciplines. However, in the last 20 years the reduction in time for anatomy teaching has further been compounded by the acute shortage of qualified anatomy teachers. Traditionally, cadaver dissection has been the cornerstone of anatomy education. Fine anatomical skills are a sine qua non for every medical student aspiring to be a surgeon or radiologist. Anatomy as it is taught in books remains theoretical and too abstract. Clinical anatomy cannot be taught in books. Hence, debate exists about best ways to teach anatomy. Ironically, most of the anatomy is re-learnt by a medical student in context to the needs of one's specific subspecialty during and after residency. Over the last decade, several technological advancements in medicine have spawned vast amounts of medical information. Imaging is increasingly being used not only for diagnosing disease conditions but also for image guided interventions and therapy. State of the art 3D imaging techniques provide an interactive, practical and realistic tool for imparting anatomy education. Superficial rote learning with 2D diagrams can be replaced with traditional didactic teaching supplanted with 3D imaging techniques. Spatial relationships of complex anatomical structures can be vividly demonstrated in three dimensions enabling a thorough understanding of the disease process.
Key Issues: 1] Describe various 3D imaging techniques that can be used as tools for teaching anatomy to medical students. 2] Demonstrate specific examples with suitable diagrams, images and video clips. 3] Provide information regarding various interactive modern Web tools available for learning anatomy.
Format: 1. Introduction. 2. 3D techniques. 3. Applications. 4. Web tools for anatomy.
Teaching Points: 1] Describe various 3D imaging techniques that can be used as tools for teaching anatomy to medical students. 2] Demonstrate specific examples from the CNS, GI, GU, pulmonary, musculoskeletal, and cardiovascular systems with suitable diagrams, images and video clips. Advanced radiographic imaging techniques that provide 3D image results such as CT, MRI, and ultrasound will be featured. 3] Provide information regarding various interactive modern Web tools available for learning anatomy.
E109. Creation and Maintenance of an Electronic Teaching File: A Community Hospital Experience
Esposito F. J.; Pirrone; S. M.; Mithalal R.; Izes B. 1. Drexel University College of Medicine, Philadelphia, PA; 2. Mercy Catholic Medical Center, Darby, PA
Address correspondence to F. Esposito (feliceesposito{at}hotmail.com)
Background: An electronic teaching file is an asset to any modern radiology residency program. We present our experience with the Radiological Society of North America's Medical Imaging Resource Center (MIRC) software package.
Key Issues: Our experience as a large community hospital radiology residency program deciding on and setting up an electronic teaching file will be described. The resources needed to set up an electronic teaching file accessible to the entire department or hospital will be presented. In addition, specific benefits of the MIRC software package will be discussed, along with the positive impact it has had on the educational experience at our institution.
Format: A didactic step-by-step approach will be utilized to describe the benefits of a MIRC-based electronic teaching file and how to go about setting up this resource.
Teaching Points: Understand the benefits of an electronic teaching file over traditional methods. Acquire an understanding of the technical factors in setting up a MIRC teaching file.
E110. Podcasting for Radiology
Golub J. A.; McNamara M. MetroHealth Medical Center, Cleveland, OH
Address correspondence to J. Golub (jgolub{at}metrohealth.org)
Background: Medical education relies on lectures and demonstrations that are brief and require the learner to observe, redact and record notes at once–a challenging task. The photocopier has allowed production of `handouts' freeing the student from some transcription. Computer and Internet technology further aids educators. Video Podcasting permits educators to record their full presentation and easily distribute it over the Internet. Podcasts allow a learner to proceed at his or her own pace, pausing where needed to digest, reflect, and take notes. Since individual learning styles differ—some students rely on visual input and others the auditory—video Podcasting is the ideal solution to make an otherwise fleeting lecture enduring, easily understood, and learned. This exhibit provides a step-by-step video demonstration of the creation and distribution of a Podcast, from start to finish. The exhibit will be available as a free download in all of the standard video formats.
Key Issues: Discussion of general radiology education.
Format: Interactive.
Teaching Points: At the completion of this activity, the participant will be able to: List the titles and sources of free and commercial software that can be used to produce quality educational Podcasts using both Windows and Macintosh platforms. Identify the benefits and constraints of Podcasting. Explain how to produce Podcasts in both Mac and Windows environments.
E111. Toward Just-in-Time Learning in Radiology
Kahn C. E.1; Santos A.1; Thao C.2; Rock J.2; Ehlers K. C.1 1. Medical College of Wisconsin, Milwaukee, WI; 2. University of Wisconsin–Milwaukee, Milwaukee, WI
Address correspondence to C. Kahn (kahn{at}mcw.edu)
Objective: Educational materials in radiology can be brought to the point of care by integrating them into clinical information systems, such as PACS. We have developed a prototype system for "just-in-time" learning in radiology. We present the performance of the current system and explore approaches to make just-in-time learning in radiology more effective and more widely available.
Materials and Methods: We incorporated design principles based on a survey of radiologists' perceived needs and interest in just-in-time learning. A database of 34 learning modules was derived from articles published in the AJR. Learning objectives were specified for each module, and multiple-choice test items were created. A Web-based system–called TEMPO–was developed to allow radiologists to select and view the learning modules. Information about clinical context, such as patient age, sex, and imaging procedure information, was exchanged between TEMPO and a simulated radiology workstation using Web services. The System Usability Scale (SUS) questionnaire was employed to evaluate the system.
Results: TEMPO identified learning modules that were relevant to the age, sex, imaging modality, and body part or organ system of the patient being viewed by the radiologist on the simulated clinical workstation. Users expressed a high degree of satisfaction with the system's design and user interface. Fifteen of 17 radiologists (88%) agreed that TEMPO displayed learning modules related to the case being reviewed. Sixteen participants (94%) believed that the length of the learning modules to be optimal.
Conclusion: Our prototype system for just-in-time learning has been received very favorably by radiologists. Such a system can be extended to create a fully functional learning management system for point-of-care learning in radiology.
E112. Imaging Spectrum of Sickle Cell Disease from Head to Toe
Kanekar S. G.1; Singh T.1; Parameswaran B.2; Moshiri S.1 1. Penn State Milton Hershey Medical Center and College of Medicine, Hershey, PA; 2. Salmaniya Medical Complex, Manama, Bahrain
Address correspondence to S. Kanekar (san17kan{at}yahoo.com)
Background: Sickle cell disease (SCD) is an inherited blood disorder which is due to mutation in the beta globin gene. Unlike normal RBC which are smooth, in SCD sickled RBCs cannot squeeze through small vessels leading to vaso-occlusive complication and; are removed from the circulation and destroyed at increased rates leading to anemia. In addition, due to various reasons like autosplenectomy, autoimmune disturbances the incidence of infection is high in these patients. In this exhibit we illustrate the spectrum of radiological presentations of SCD in various anatomic locations.
Key Issues: We discuss and illustrate the imaging features of SCD affecting the various organs and systems. For the purpose of this exhibit we have classified this disease presentation, depending on the effect and sequelae of three major etiopathogenesis namely: 1) Hemolytic anemia, 2) Vaso-occlusive changes/infarction and 3) Infection. Radiological changes due to these mechanisms involving the brain, lungs, cardiac, liver, spleen, kidney, muscles, bones and subcutaneous tissues and skin are presented. Familiarity with these radiological features will help ensure correct diagnosis and treatment in pediatric as well as adult patients.
Format: Our presentation will be a didactic electronic exhibit in the format of a pictorial assay, illustrating the imaging features of SCD from head to toe.
Teaching Points: 1) To review the spectrum of radiological presentation of SCD in various anatomic locations. 2) To discuss the typical and atypical imaging features and formulate the differential diagnosis. This exhibit will be a core learning tool for sickle cell disease.
E113. The Role of CT Imaging in Crash Test Analyses
Sammet S.1; Koch R.1; Bolte J. H.2; Knopp M. V.1 1. The Ohio State University, Department of Radiology, Columbus, OH; 2. The Ohio State University, Division of Anatomy, Columbus, OH
Address correspondence to S. Sammet (sammet.5{at}osu.edu)
Objective: Automotive crash testing has saved thousands of lives by making cars safer. A major problem of crash test research is to find quantitative methods to describe injuries of the human body caused by a car accident. The aim of this study is to demonstrate the role of CT imaging in crash test analyses with human cadavers to create a model for oblique and lateral impacts on human thoraxes. Human response to oblique and lateral impact is of great importance in defining the biomechanical response of the human thorax in a vehicle crash.
Materials and Methods: After extensive tests with crash-test dummies two human cadavers were hit with a device that simulates a blunt impact with defined forces and velocities in oblique and lateral directions equivalent to that in car accidents. CT imaging of the human cadavers was performed on a clinical CT scanner (SOMATOM Sensation, Siemens Medical Solutions). Acquisition parameters: 120 kV, slice thickness = 1.5 mm, FOV = 40 cm, matrix 512 x 512. The rib cages of the cadavers were scanned before and after treatment to evaluate the damage caused by the impact. The examination was performed in agreement with the IRB protocol and with informed consent from the patients when they were still alive.
Results: Injuries of the ribcage caused by the simulated car accident could be identified on the CT scans. The results of CT imaging correlate with the analyses of high speed videos and data from sensors attached to more than 30 locations of the thorax during the impact. 3D reconstructions of the ribcage were done before and after the crash to visualize the injuries after oblique and lateral impacts and were confirmed by an autopsy.
Conclusion: CT imaging of ribcage injuries is consistent with independent methods and allows the quantification of forces and damages to the human body during car accidents. The data evaluation and reconstruction helped to develop a model for oblique and lateral impacts on human thoraxes. Crash test injuries analyzed with CT imaging provides data to develop safer cars in the future and consequently reduces the severity of injuries during car accidents.
E114. Interactive PET/CT Brain Quiz
Vinocur D. N.; Oneto J.; Jose J.; Zell S.I.; Smoak W. Mount Sinai Medical Center, Miami Beach, FL
Address correspondence to D. Vinocur (vinocur{at}hotmail.com)
Background: As the population ages, a greater need for accurate diagnosis and classification of patients with suspected dementia has ensued. Conventional clinical assessment and magnetic resonance imaging may not reveal the etiology of these disorders or may only do so once morphological changes have occurred. Brain biopsy carries a high morbidity and mortality and is not commonly performed. F18-FDG positron emission tomography (PET) of the brain provides functional information and may accurately identify the presence of metabolic parenchymal dysfunction and, in many instances the specific pathologic process. In selected cases, an alternative diagnosis is incidentally discovered. Extensive background literature describes the anatomical distribution of impairment throughout the brain for the most common forms of dementias. These patterns of abnormalities are the basis for F18-FDG PET specific disease recognition and constitute the theme of this presentation.
Key Issues: A series of selected F18-FDG PET/CT brain studies will be presented that are representative of the multiple dementia syndrome etiologies such as Alzheimer's disease (early and late), fronto-temporal dementia, multi-infarct dementia, AIDS dementia complex, normal pressure hydrocephalus as well as other nondegenerative disorders that clinically mimic dementia such as advanced brain neoplasm or extra-axial collections. In addition, incidental findings will be shown as they may radiographically appear only as subtle metabolic changes. Correlative MRI and CT scans, as well as pathology will be provided for complete characterization.
Format: A series of F18-FDG PET/CT brain scans will be presented sequentially as "unknown cases" in an electronic quiz format, where the user will have the opportunity to formulate a specific diagnosis for every case. Once the user has answered an individual case, the same case will be presented again, but with labels and arrows pointing at the radiological findings as well as additional correlative imaging that will include MRI, CT scans and pathology. A brief discussion of the disease entity will follow as well as a summary of the key diagnostic findings. The next case will then be presented in a similar manner.
Teaching Points: Highlight the radiologic findings and metabolic patterns of the most common dementia syndromes when imaged with f18-FDG PET/CT. Unexpected findings are also presented to emphasize their existence and their potential role as possible culprits of the patient's symptoms.
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