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NEWS - Radiology

Prevalence and outcomes of incidental imaging findings: umbrella review – The BMJ (free)

Related: Giles Maskell: Incidental anarchy – The BMJ Opinion (free)

“Incidentalomas. If you order imaging studies, you know they are a problem. This meta-analysis quantifies incidentaloma prevalence for specific types of imaging. For MRI of the brain, the prevalence was 22% (95%CI 14 to 31) (via @RasoiniR and @eloder, see Tweet)


Incidental anarchy – The BMJ Opinion (free)

“Giles Maskell writes on over diagnosis and underdiagnosis, the complexities of incidental findings and urges clinicians to “Think before you scan because you can” (via @bmj_latest see Tweet)

Coronary Computed Tomography Angiography vs Functional Stress Testing for Patients With Suspected Coronary Artery Disease: A Systematic Review and Meta-analysis – JAMA Internal Medicine (free)

Invited commentary: Coronary Computed Tomographic Angiography—The First Test for Evaluating Patients With Chest Pain? (free)

Commentary: Coronary CT Angiography vs. Stress Testing: Meta-Analysis Offers Mixed Results – Physician’s First Watch (free)

Coronary Computed Tomografic Angiography (CCTA) was associated with a very small reduction in the incidence of myocardial infarction (0.7% vs 1.1% = 0.4% absolute risk reduction), but without differences in death or cardiac hospitalization. Patients undergoing CCTA were significantly more likely to undergo invasive coronary angiography (11.7% vs 9.1%), revascularization (7.2% vs 4.5%) and were also more likely to receive a diagnosis of new CAD and to have initiated aspirin or statin therapy.


Acute Kidney Injury After Computed Tomography: A Meta-analysis – Annals of Emergency Medicine (link to abstract – $ for full-text)

Commentary: When kidneys are injured, CT contrast isn’t the culprit – Health Imaging (free)

Related article: Risk of Acute Kidney Injury After Intravenous Contrast Media Administration – Annals of Emergency Medicine (free)

Source: Hospital Medicine Virtual Journal Club

Compared with noncontrast CT, contrast-enhanced CT was not significantly associated with either acute kidney injury, need for renal replacement therapy, or all-cause mortality.


Updated: Practice Parameters and Technical Standards – American College of Radiology (free)

News release: New, Revised Guidance Documents Cover 35 Radiology Topics – American College of Radiology, via NewsWise (free)

The American College of Radiology developed 3 new guidance documents and revised 32 others to advance the science of radiology and improve the quality of service to patients


The 10-Year Prognostic Value of Zero and Minimal CAC – Journal of The American College of Cardiology (no abstract – $ for full text)

Commentary: Calcium in Arteries Influences Heart Attack Risk –  UT Southwestern Medical Center, via NewsWise (free) AND Study: Calcium in arteries influences heart attack risk – UPI (free)

“Half of the participants had no calcium deposits in their arteries or a zero coronary artery calcium, or CAC, score, and had less than a 3 percent chance of a cardiovascular event over a 10-year period despite having other risk factors for heart disease and stroke such as type 2 diabetes, high blood pressure and high bad cholesterol levels” (from UPI)


Magnetic Resonance in Transthyretin Cardiac Amyloidosis – Journal of The American College of Cardiology (free)

Commentary: Magnetic Resonance in Transthyretin Cardiac Amyloidosis – American College of Cardiology, Latest in Cardiology (free)

“This study adds to a rich body of literature supporting the use of CMR in patients with known or suspected amyloidosis” (from Latest in Cardiology)


Amyloid PET a ‘Game Changer’ for MCI Diagnosis – Medscape (free registration required)

Coverage from the Alzheimer’s Association International Conference (AAIC) 2017


Perspectives: Augmenting diagnostic vision with AI – The Lancet (free registration required)


Viewpoint: The Future of Radiology and Artificial Intelligence – The Medical Futurist (free)

“Radiologists who use AI will replace those who don’t”.


Giles Maskell: The practice of radiology needs to change – The BMJ Opinion (free)

“The practice of radiology is unsafe and needs to change says, Giles Maskell” (RT see Tweet)


Screening for Thyroid Cancer: US Preventive Services Task Force Recommendation Statement – JAMA (free)

Editorial 1: The USPSTF Recommendation on Thyroid Cancer Screening: Don’t “Check Your Neck” (free)

Editorial 2: Cancer Screening, Overdiagnosis, and Regulatory Capture (free)

Editorial 3: How to Look for Thyroid Cancer (free)

Commentaries: No Symptoms, No Thyroid Screening, Says USPSTF – Medscape (free registration required) AND Don’t Screen For Thyroid Cancer, Task Force Says – NPR Health News (free) AND USPSTF Says No to Thyroid Cancer Screening – MedPage Today (free registration required)

The USPSTF recommended against screening for thyroid cancer in asymptomatic adults with “grade D” recommendation (Grade D = “The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits”).


Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017 – Radiology (free)

Source: Management of Pulmonary Nodules Found Incidentally on Computed Tomography Scans – Journal Watch (free)

Incidental pulmonary nodules discovered outside the context of screening or cancer follow-up are increasingly common in clinical practice. The purpose of these updated recommendations is to reduce the number of unnecessary follow-up examinations while providing practical guidance on follow-up intervals for selected larger nodules.


ACR Appropriateness Criteria Adds Topics, Covers More Clinical Variants Than Ever Before (free)

Browse Appropriateness Criteria Topics (free)

Source: Newswise

This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.


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