Automated Structured Reporting for Thyroid Ultrasound: Effect on Reporting Errors and Efficiency

PurposeTo compare the effectiveness of different reporting templates using the ACR Thyroid Imaging Reporting and Data System (TI-RADS) for thyroid ultrasound.MethodsIn this retrospective study, four radiologists implemented ACR TI-RADS while dictating 20 thyroid ultrasounds for each of four different templates: free text, minimally structured, fully structured, fully structured and automated (embedded software automatically sums TI-RADS points, correlates with nodule size, and inserts appropriate recommendation into report impression). In total, 80 reports were constructed per template type. Frequencies of different errors related to ACR TI-RADS were recorded: errors in point assignment, point addition, risk-level assignment, and recommendation. Reporting times were recorded, and a survey about using the template was administered. Differences in error rates were compared using χ² and Fisher’s exact tests, and differences in reporting times were compared using Kruskal-Wallis tests.ResultsAcross all readers, errors were identified in 27.5% of reports (22 of 80) for the free text template, 28.8% (23 of 80) for the minimally structured template, 18.8% (15 of 80) for the fully structured template, and 0% (0 of 80) for the fully structured and automated template (P < .0001). Frequency of each error type (number assignment, addition, TR categorization, recommendation) decreased across the four templates (P < .0005 to P < .005). Median reporting times for the less complex templates were 210 to 240 seconds, whereas the median automated template reporting time was 180 seconds (P = .41). Radiologists subjectively preferred using the automated template.ConclusionA structured reporting template for thyroid ultrasound that automatically executed steps of ACR TI-RADS resulted in fewer reporting errors for radiologists.     

BRCA1/2基因检测报告模板专家指导意见（2021年版）

BRCA1/2基因是抑癌基因，通过与其他肿瘤抑制因子和调节细胞分裂蛋白等相互作用，参与DNA损伤修复和转录调控，在维持细胞遗传信息的稳定性方面发挥至关重要的作用，并通过调控其他基因的活性，在胚胎发育中起着重要作用［1-2］。     

Reduction of radiation dose during facet joint injection using the new image guidance system SabreSource™: a prospective study in 60 patients

Interventional procedures are associated with high radiation doses for both patients and surgeons. To reduce the risk from ionizing radiation, it is essential to minimize radiation dose. This prospective study was performed to evaluate the effectiveness in reducing radiation dose during facet joint injection in the lumbar spine and to evaluate the feasibility and possibilities of the new real time image guidance system SabreSource™. A total of 60 patients, treated with a standardized injection therapy of the facet joints L4–L5 or L5–S1, were included in this study. A total of 30 patients were treated by fluoroscopy guidance alone, the following 30 patients were treated using the new SabreSource™ system. Thus a total of 120 injections to the facet joints were performed. Pain, according to the visual analogue scale (VAS), was documented before and 6 h after the intervention. Radiation dose, time of radiation and the number of exposures needed to place the needle were recorded. No significant differences concerning age (mean age 60.5 years, range 51–69), body mass index (mean BMI 26.2, range 22.2–29.9) and preoperative pain (VAS 7.9, range 6–10) were found between the two groups. There was no difference in pain reduction between the two groups (60 vs. 61.5%; P = 0.001) but the radiation dose was significantly smaller with the new SabreSource™ system (reduction of radiation dose 32.7%, P = 0.01; reduction of mean entrance surface dose 32.3%, P = 0.01). The SabreSource™ System significantly reduced the radiation dose received during the injection therapy of the lumbar facet joints. With minimal effort for the setup at the beginning of a session, the system is easy to handle and can be helpful for other injection therapies (e.g. nerve root block therapies).     

3D representation of the developing chick knee joint: a novel approach integrating multiple components

The knee joint has a highly complex 3-dimensional (3D) morphology that is sculpted at the interface of the forming long bones as they are generated in the embryo. Although it is clear that regulatory genes guide joint formation, the mechanisms that are responsible for morphogenesis of the knee are poorly understood. Certainly the process involves integration across several tissues and physical/mechanical influences from neighbouring tissues are important. We describe the acquisition of shape in the chick knee joint in detail and show that by HH34 the joint already displays shape characteristics of the adult structure. Through imaging developing cartilage, tendons, ligaments and muscle across developmental stages from HH28–34 we have built 3D representations of the forming structure including the various components important in knee formation. We describe the timing of muscle and tendon development in parallel with the refinement of cartilage shape, showing when and where (tendon attachment points) muscle forces are applied to the cartilage elements. Shape begins to emerge as the tendons are forming (HH30–32) but is fully refined (HH34) in the presence of tendons. The resulting integrated 3D representations of the developing knee across time will serve as the foundation for computational analysis of the mechanical environment, and experimental approaches to investigating morphogenetic mechanisms.     

How to operate a liver tumor you cannot see

Backround  As recent chemotherapy regimens for metastatic colorectal cancer become more and more effective in a neoadjuvant setting before liver surgery, a “complete” clinical response is sometimes documented on imaging. Without operation though, metastatic recurrence is likely to commence within 12 months. Surgeons now face the problem to resect non-visualizable and non-palpable lesions. Methods  Computer-based virtual surgery planning can be used to fuse pre- and postchemotherapy computed tomography data to develop an operative strategy. This information is then intraoperatively transferred to the liver surface using an image-guided stereotactically navigated ultrasound dissector. This enables the surgeon to perform a resection that is otherwise not possible. Results  During operation, detection of the lesion through palpation or ultrasound was impossible. After registering the virtual operation plan into the navigation system, the planned resection was performed without problems. Histopathologic workup showed vital tumor cells in the specimen. Conclusion  The new image-guided stereotactic navigation technique combined with virtual surgery planning can solve the surgeon’s dilemma and yield a successful operation. “Best of Abstracts—Chirurgisches Forum 2009, Deutsche Gesellschaft für Chirurgie”     

Egocentric memory impaired and allocentric memory intact as assessed by virtual reality in subjects with unilateral parietal cortex lesions

Present evidence suggests that medial temporal cortices subserve allocentric representation and memory, whereas egocentric representation and memory mainly depends on inferior and superior parietal cortices. Virtual reality environments have a major advantage for the assessment of spatial navigation and memory formation, as computer-simulated first-person environments can simulate navigation in a large-scale space. However, virtual reality studies on allocentric memory in subjects with cortical lesions are rare, and studies on egocentric memory are lacking. Twenty-four subjects with unilateral parietal cortex lesions due to infarction or intracerebral haemorrhage (14 left-sided, 10 right-sided) were compared with 36 healthy matched control subjects on two virtual reality tasks affording to learn a virtual park (allocentric memory) and a virtual maze (egocentric memory). Subjects further received a comprehensive clinical and neuropsychological investigation, and MRI lesion assessment using T₁, T₂ and FLAIR sequences as well as 3D MRI volumetry at the time of the assessment. Results indicate that left- and right-sided lesioned subjects did not differ on task performance. Compared with control subjects, subjects with parietal cortex lesions were strongly impaired learning the virtual maze. On the other hand, performance of subjects with parietal cortex lesions on the virtual park was entirely normal. Volumes of the right-sided precuneus of lesioned subjects were significantly related to performance on the virtual maze, indicating better performance of subjects with larger volumes. It is concluded that parietal cortices support egocentric navigation and imagination during spatial learning in large-scale environments.