Real-world cases, relevancy to practice, and real strategies for implementation—these are the takeaways from education sessions delivered at the annual RSNA conference. Some of the notable presentations from this year are summarized here. For full-length stories these presentations and more, visit RSNA360.HealthImaging.com.
Katherine Andriole, PhD, of Brigham and Women’s Hospital in Boston, foresees a bright future for CR and DR. She predicted the technology will get faster and smaller, decrease in cost, and offer value-added tools for image-intense specialties. However, its use in mammography poses challenges for PACS workflow due to image size and workstation interpretation requirements.
Khan Siddiqui, MD, from the VA Maryland Health Care System in Baltimore said repetitive use of conventional user input devices such as the mouse and keyboard are associated with musculoskeletal injuries. He noted that alternative input devices including trackballs, roller mice, tablets and game controllers show promise.
Siddiqui’s colleague, Eliot Siegel, MD, said that ergonomics is a serious business from both productivity and health perspectives. As such, radiology departments must promote healthy, low-stress reading environments.
“PACS workstations aren’t keeping pace with the increase in imaging volume,” said Steven Horii, MD, from the Hospital of University of Pennsylvania in Philadelphia.
Horii encouraged a focus on integration, automation, task-appropriate controls and user interfaces, and environments conducive to task management.
Aldo Badano, MD, with the Laboratory for the Assessment of Medical Imaging Systems at the FDA, said that informatics professionals must accurately assess display systems to provide radiologists the optimal start point for their image interpretation.
Martin Pomper, MD, PhD, of Johns Hopkins University in Baltimore, said radiology is evolving from anatomic-based diagnostic imaging to functional and hybrid imaging technologies.
Current research is focused on three areas: new imaging probes and technologies; drug development, imaging gene delivery and expression; and understanding cellular processes.
King Li, MD, from the National Institutes of Health Clinical Center, cautioned that radiologists could be taken out of the diagnosis and treatment loops if molecular medicine proceeds without diagnostic imaging.
David Gilmore from Beth Israel Deaconess Hospital in Boston discussed technology on the hybrid imaging horizon, including MR/CT, PET/MR and PET/mammo.
“We really are at the beginning of our learning curve in digital mammo,” said Margarita Zuley, MD, from the University of Pittsburgh Medical Center.
Factors that challenge the reading of digital mammograms are: high volume; short viewing time; complex image interpretation; extremely low cancer incidence at screening; and human factors such as interruptions and fatigue.
“Perception in digital mammography is influenced by factors, the most important of which is the patient changing over time,” said Zuley. “The second most important influence is us [the radiologist] and our goal to perceive those changes given all the different variables we are dealing with in digital mammography.”
Matthew Freedman, MD, from Georgetown University Medical Center in Washington, D.C., said that computer-aided detection (CAD) improved the detection of “things,” which are eventually deemed benign, malignant or actionable. He said that with the assistance of CAD, more benign and malignant things will be seen.
Michael Ulissey, MD, from the University of Texas Southwestern Medical Center in Dallas, said that: “We have to tell the good white from the bad white in mammograms for detecting breast cancer,” which is more complicated in denser breasts.
He encouraged his fellow radiologists to use the detection technology because “CAD can be our greatest ally.”
James Borgstede, MD, of the University of Illinois College of Medicine in Chicago, said that “what is best for the patient is best for the physician and changing practice requires a healthcare team effort.”
He said that for project success, the entire healthcare team needs to be involved; physicians need to be involved in the project; and all team members must have specific topics.
Paul Nagy, PhD, from the University of Maryland Medical Center in Baltimore, suggested that accelerated pace and performance pressure have left quality