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Objectives: To evaluate the effectiveness of cryoablation compared to partial nephrectomy in patients with stage IA papillary and chromophobe renal cell carcinoma (pRCC; chRCC). Material and methods: The 2004–2016 National Cancer Database was queried for adult patients with stage IA pRCC or chRCC treated with cryoablation or partial nephrectomy. Patients receiving systemic therapy or radiotherapy, as well as those with bilateral RCC or prior malignant disease were excluded. Overall survival (OS) was assessed using Kaplan–Meier plots and Cox proportional hazard regression models. Nearest neighbor propensity matching (1:1 cryoablation:partial nephrectomy, stratified for pRCC and chRCC) was used to account for potential confounders. Results: A total of 11122 stage IA renal cell carcinoma patients were included (pRCC 8030; chRCC 3092). Cryoablation was performed in 607 (5.5%) patients, and partial nephrectomy in 10515 (94.5%) patients. A higher likelihood of cryoablation treatment was observed in older patients with non-private healthcare insurance, as well as in those with smaller diameter low-grade pRCC treated at non-academic centers in specific US geographic regions. After propensity score matching to account for confounders, there was no statistically significant difference in OS comparing cryoablation vs partial nephrectomy in patients with pRCC (HR = 1.3, 95% CI: 0.96–1.75, p = 0.09) and those with chRCC (HR = 1.38, 95% CI: 0.67–2.82, p = 0.38). Conclusion: After accounting for confounders, cryoablation, and partial nephrectomy demonstrated comparable OS in patients with stage IA papillary and chromophobe RCC. Cryoablation is a reasonable treatment alternative to partial nephrectomy for these histological RCC subtypes when radiologically suspected or diagnosed after biopsy. Critical relevance statement: Cryoablation might be considered as an upfront treatment alternative to partial nephrectomy in patients with papillary and chromophobe stage IA renal cell carcinoma, as both treatment approaches yield comparable oncological outcomes. Key Points: The utilization of cryoablation for stage IA papillary and chromophobe RCC increases. In the National Cancer Database, we found specific patterns of use of cryoablation. Cryoablation and partial nephrectomy demonstrate comparable outcomes after accounting for confounders. [ABSTRACT FROM AUTHOR]

To assess epidemiology, clinical presentation, treatment and overall survival of adult patients with renal sarcomas, the 2004–2016 SEER and NCDB databases were queried for adult patients diagnosed with renal sarcoma, calculating average annual age-adjusted incidence rates (AAIR) and average annual percentage change (AAPC) as well as overall survival (OS). In n = 1279 included renal sarcoma patients, AAIR remained constant over the study period (average 0.53 cases/1million; AAPC = 0.7, p = 0.6). Leiomyosarcoma (AAIR 0.14 cases/1 million) and malignant rhabdoid tumors (0.06 cases/1 million) were most common. Sarcoma histiotypes demonstrated considerable heterogeneity regarding demographic and cancer-related variables. Patients presented with advanced local extent (T3 33.3%; T4 14.2%) or distant metastases (29.1%) and commonly underwent surgical resection (81.6%). Longer OS was independently associated with younger age, female sex, lower comorbidity index, low T stage, negative surgical margins, absence of tumor necrosis or distant metastases and leiomyosarcoma histiotype (multivariable p < 0.05 each). Treatment efficacy varied according to sarcoma histiotype (interaction p < 0.001). Accounting for 0.25% of renal malignancies, renal sarcomas include 43 histiotypes with distinct epidemiology, clinical presentation, outcomes and sensitivity to systemic therapy, thereby reflecting soft-tissue sarcoma behavior. Renal sarcoma treatment patterns follow recommendations by renal cancer guidelines with surgical resection as the cornerstone of therapy. [ABSTRACT FROM AUTHOR]

• MOLLI and T1FLASH sequences can be used for T1mapping of the prostate. • Contrast media accumulation at the bladder base limits T1mapping. • In post-GBCA, T1FLASH yields superior image quality over MOLLI sequences. • T1FLASH demonstrates reduced artifact burden over MOLLI sequences. To assess artifact burden and image quality of different MRI T1 mapping techniques of the prostate. Participants with suspected prostate cancer (PCa) were prospectively enrolled from June-October 2022 and examined with multiparametric prostate MRI (mpMRI; 3 T scanner; T1wi, T2wi, DWI und DCE). T1 mapping was performed before and after administration of gadolinium-based contrast-agent (GBCA) using (i) a modified Look-Locker inversion (MOLLI) technique and (ii) a novel single-shot T1FLASH inversion recovery technique. T2wi, DWI, T1FLASH and MOLLI sequences were systematically examined regarding prevalence of artifacts and image quality using a 5-point Likert-Scale. A total of n = 100 patients were included (median age: 68 years). T1FLASH maps (pre-and post-GBCA) showed metal artifacts in 7% of cases and susceptibility artifacts in 1%. For MOLLI maps, pre-GBCA metal and susceptibility artifacts were documented in 6.5% of cases each. MOLLI maps post-GBCA showed artifacts in 59% of cases resulting primarily from urinary GBCA excretion and GBCA accumulation at the bladder base (p < 0.01 versus T1FLASH post-GBCA). Image quality for T1FLASH pre-GBCA was rated at a mean 4.9+/-0.4 and for MOLLI at 4.8+/-0.6 (p = 0.14). Post-GBCA image quality was rated at a mean 4.9+/-0.4 for T1FLASH and at 3.7+/-1.1 for MOLLI (p < 0.001). T1FLASH maps provide a fast and robust method for quantification of T1 relaxation times of the prostate. T1FLASH is suitable for T1 mapping of the prostate following administration of contrast agents, while MOLLI T1 mapping is impaired through GBCA accumulation at the bladder base leading to severe image artifacts and reduced image quality. [ABSTRACT FROM AUTHOR]

Background: In addition to the objectifiable treatment quality, patients' perspectives are gaining relevance., Objective: This study aimed to characterize available hospital rating websites (HRW) with regards to patient ratings and to compare them with data from hospital quality reports and quality assurance based on routine data (QSR) for urological departments., Materials and Methods: After a structured online search for HRWs, websites were compared based on patient ratings from the 10 urologic departments with the largest intervention rates in 2021 using generalized estimated equations. For radical prostatectomy (RPE), quantitative comparison of patient ratings (klinikbewertungen.de) and QSR-based ratings was performed using Spearman's rank correlation., Results: Of 1845 hits, 25 portals were analyzed. The department-wise comparison of HRWs resulted in significantly different patient ratings (p < 0.001). Patient ratings (klinikbewertungen.de) and QSR data (AOK-Gesundheitsnavigator) showed no significant correlation. An internal comparison of QSR data and patient ratings from the AOK-Gesundheitsnavigator on RPE showed a significant negative correlation between the overall rating and unplanned reoperations (r = -0.81) or other complications (r = -0.91). There was no significant correlation with the recommendation rate by patients., Conclusion: Hospital rating websites show considerable heterogeneity regarding patient ratings of the same urology department in different portals. Furthermore, based on the selected examples, there seems to be no correlation between subjective and objective evaluations between different websites or within one website., (© 2024. The Author(s).)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Purpose:  The role of today's hospital-based radiologists goes far beyond interpretation-related tasks. This observational study defines these types of activities and quantifies the type of value-adding interactions radiologists experience on a daily basis with referring departments and other health personnel. The purpose of this study is to evaluate the quality and quantity of these value-adding non-image interpretation tasks in the daily routine of hospital-based residents and attending radiologists., Methods:  A prospective, observational study was performed in the radiology department of a German university hospital. Two experienced radiologists performed a 30-day observation of the entire medical staff. The observers followed the subject radiologists throughout the workday, recording activities using a time and motion methodology. An evaluation matrix was developed to characterize and quantify image interpretation tasks (IITs), non-image interpretation tasks (NITs), and contingency allowance (CA) for residents and attending radiologists. Here, the example of the MRI unit is used., Results:  Four main categories of responsibilities for NITs were identified including teaching and education, clinical decision support, management and organization, and patient care. The quantitative analysis for residents showed: IITs 15 h/d (53 %), NITs 9.8 h/d (34 %), CA 2.2 h/d (13 %). For attendings the analysis revealed: IITs 6.7 h/d (40 %), NITs 7.8 h/d (47 %), and CA 1.7 h/d (13 %). This resulted in staff requirements of 2 attendings and 3.4 residents for the MRI unit. On average, 6 TSEs/h occurred in the case of residents and 13 TSEs/h in the case of attendings., Conclusion:  NITs consumed a significant portion of a radiologist's workday. Therefore, the number of examinations performed is not a reliable surrogate for the daily workload of hospital-based radiologists especially in cross-sectional imaging units. Though time-consuming, these non-interpretive tasks are greatly contributing to the fact that modern radiology is assuming a central position in patient management, fulfilling a critical role that surpasses image interpretation-related tasks to include a more integrative and consultative role. These findings will help to further define the changing role of radiologists with respect to other physicians, non-medical personnel, hospital administrators, as well as policy makers., Key Points:   · Staff requirements are a significant factor in department strategy.. · Targeted analysis can deliver valuable information about workload per activity and the required staff.. · The number of examinations performed is not a reliable surrogate for the daily workload of hospital-based radiologists.. · NITs comprise a significant portion of a radiologist's workday.. · Though time-consuming, non-interpretive tasks contribute to the fact that modern radiology is assuming a central role in patient management.., Citation Format: · Streit U, Uhlig J, Lotz J et al. Qualitative and Quantitative Workplace Analysis of Staff Requirement in an Academic Radiology Department. Fortschr Röntgenstr 2021; 193: 1277 - 1284., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)