Surprise, surprise

Surprise seems to be the common element in Health Imaging’s top stories this week. Some are genuine and offer the opportunity to reflect on, and perhaps amend, conventional approaches to practice. Others bring a different response—best expressed as the proverbial “I told you, so.”

Take for example the study published in the January issue of the American Journal of Roentgeneology. After the researchers implemented a screening and educational program prior to thoracic CT angiography for children ages 5 or younger, 70 percent of patients underwent the CT exam without sedation. It’s great news for parents and children and brings an opportunity for patient-centered pediatric imaging.

The controversial link between contrast and contrast-induced nephropathy received a knock, courtesy of the study published Jan. 14 in Radiology. In this meta-analysis, researchers reviewed 13 nonrandomized studies and found similar risk of acute kidney injury among patients who underwent CT scanning with and without IV contrast.

For years, radiology researchers and ergonomists have contended that radiology might be well-served by adapting some gaming tools for use in the reading room. Surgeons may benefit as well, according to a research team from Purdue University in West Lafayette, Ind. Researchers reconfigured a gesture-recognition system, developed for the XBOX gaming system, for use in the operating room. The technology allowed surgeons to browse MRI images sans keyboard or mouse.

In the less shocking category came the JAMA Dermatology study that showed educational apps designed to help consumers assess whether a skin lesion is potentially melanoma or not provide overall poor and highly variable performance. Despite disclaimers specifying educational rather than diagnostic use, these apps might harm patients who mistakenly believe the evaluation serves as a substitute for medical advice, cautioned Joel A. Wolf, BA, from the University of Pittsburgh, and colleagues.  

Another not-so-surprising finding was published Jan. 14 in Annals of Internal Medicine. A survey of state medical boards revealed that the online behaviors most likely to spur an investigation mirrored established offline standards for professional behaviors.

In other words, keep it honest, keep it clean, keep it professional. However, given the existence of multiple gray areas, the authors called for more continuing education of physicians in practice about potential interpretations and consequences of online actions so that their social media presence can be a professional benefit instead of a liability.

And finally, complete access and knowledge of the patient’s clinical history and condition, paired with radiologists’ knowledge of the benefits and limits of additional imaging, could help to reduce unnecessary additional imaging after oncologic PET/CT exams, according to authors of a study published in the January issue of Clinical Radiology.

A.B. Shinagare, MD, from the department of radiology at Brigham and Women’s Hospital in Boston, and colleagues found nuclear medicine physicians and radiologists recommended additional imaging in approximately one-third of PET/CT reports, but more than half of these recommendations were unnecessary, according to a study published in the January issue of Clinical Radiology. Ordering clinicians followed recommendations for further imaging in less than one-third of the reports.

What surprises have you learned from this week? Please email and let us know.

Lisa Fratt, editor