Alexander, Lauren F

Medical simulation training can be used to improve clinician performance, teach communication and professionalism skills, and enhance team training. Radiology residents can benefit from simulation training in diagnostic ultrasound, procedural ultrasound, and communication skills prior to direct patient care experiences. This paper details a weeklong ultrasound simulation training curriculum for radiology residents during the PGY‐1 clinical internship. The organization of established teaching methods into a dedicated course early in radiology residency training with the benefit of a multi‐disciplinary approach makes this method unique. This framework can be adapted to fit learners at different skill levels or with specific procedural needs.

AbstractBackgroundAbdominal arterial calcification (AAC) is common among candidates for kidney transplant. The aim of this study is to correlate AAC score value with post‐kidney transplant outcomes.MethodsWe modified the coronary calcium score by changing the intake data points and used it to quantitate the AAC. We conducted a retrospective clinical study of all adult patients who were transplanted at our center, between 2010 and 2013, and had abdominal computed tomography scan done before transplantation. Outcomes included mortality, pulse pressure (PP) measured by 24 h ambulatory blood pressure monitoring system, and kidney allograft function measured by iothalamate clearance.ResultsFor each 1000 increase of AAC score value, there is an associated 1.05 increase in the risk of death (95% CI 1.02, 1.08) (p < 0.001). Overall median AAC value for all patients was 1784; Kaplan–Meier curve showed reduced survival of all‐cause mortality for patients with AAC score value above median and reduced survival among patients with cardiac related mortality. The iothalamate clearance was lower among patients with total AAC score value above the median. Patients with abnormal PP (< 40 or > 60 mmHg) had an elevated median AAC score value at 4319.3 (IQR 1210.4, 11097.1) compared to patients with normal PP with AAC score value at 595.9 (IQR 9.9, 2959.9) (p < 0.001).ConclusionWe showed an association of AAC with patients’ survival and kidney allograft function after kidney transplant. The AAC score value could be used as a risk stratification when patients are considered for kidney transplant.

Purpose: To investigate the potential for decreasing radiation dose when utilizing a third-generation vs second-generation dual-source dual-energy CT (dsDECT) scanner, while maintaining diagnostic image quality and acceptable image noise. Materials and Methods : Retrospective analysis of patients who underwent dsDECT for clinical suspicion of urolithiasis from October 2, 2017, to September 5, 2018. Patient demographics, body mass index, abdominal diameter, scanning parameters, and CT dose index volume (CTDIvol) were recorded. Image quality was assessed by measuring the attenuation and standard deviation (SD) regions of interest in the aorta and in the bladder. Image noise was determined by averaging the SD at both levels. Patients were excluded if they had not undergone both third- and second-generation dual-energy CT (DECT), time between DECT was more than 2 years, or scan parameters were outside the standard protocol. Results: A total of 117 patients met the inclusion criteria. Examinations performed on a third-generation DECT had an average CTDIvol 12.3 mGy, while examinations performed on a second-generation DECT had an average CTDIvol 13.3 mGy ( p < 0.001). Average image noise was significantly lower for the third-generation DECT (SD = 10.3) compared with the second-generation DECT (SD = 13.9) ( p < 0.001). Conclusions: The third-generation dsDECT scanners can simultaneously decrease patient radiation dose and decrease image noise compared with second-generation DECT. These reductions in radiation exposure can be particularly important in patients with urinary stone disease who often require repeated imaging to evaluate for stone development and recurrence as well as treatment assessment.