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Purpose: Breast imaging accounts for a large proportion of medico-legal cases involving radiologists in several countries and may be a disincentive to breast imaging. As this has not been well studied in Canada, we evaluated the key medico-legal issues of breast imaging in Canada and their implications for health care providers and patient safety. Methods: In collaboration with Canadian Medical Protective Association (CMPA), we obtained information from the medico-legal repository, including civil-legal, medical regulatory authority (College) and hospital complaints occurring between 2002-2021. Canadian Classification of Health Interventions (CCI) codes were used for breast imaging and biopsy. Trend analysis was done comparing cases involving breast imaging/biopsy to all cases where a radiologist was named. Results: Radiologists were named in 3108 medico-legal cases, 188 (6%, 188/3108) of which were CCI coded for breast imaging or biopsy. Factors related to radiologists were most frequent (64%, 120/188), followed by team (23.4%, 44/188) and system (6.9%, 13/188). Equal representation of male and female radiologists was found (IRR = 1.22; 95% CI:.89, 1.56). In a 10-year test window from 2006 - 2015 we identified an increasing trend for all cases involving radiologists (P = 0,0128) but a decreasing trend for cases coded with breast imaging or biopsy (P = 0,0099). Conclusions: A significant decrease in cases involving breast imaging were found from 2006-2015, accounting for 6% of the medico-legal cases. The lower risk of breast imaging medico-legal issues may encourage more radiologists in breast imaging. [ABSTRACT FROM AUTHOR]

Purpose: To examine national trends in the adoption and use of the LI-RADS Treatment Response Algorithm. Methods: Members of the Society of Abdominal Radiology (SAR) Disease-Focused Panel (DFP) on LI-RADS Treatment Response (LR-TR) of hepatocellular carcinoma (HCC) developed a 15-question survey which was distributed to radiologists at academic and private practice institutions around the USA and Canada. The survey focused on HCC-related practice patterns as well as the adoption and use of the LR-TR algorithm. Results: Of 122 surveys distributed, a total of 76 radiologists responded (62%). Responders were predominantly from academic centers (85%). Nearly all (96%) participate in multidisciplinary hepatic tumor boards and most (67%) have an active liver transplant program. All responders' institutions perform locoregional therapy for HCC, including radiation-based therapy (TARE and SBRT). There was a preference for use of MRI over CT for follow-up after locoregional therapy. All responders were aware of the LR-TR algorithm and nearly all (92%) used the system in routine practice. Radiologists expressed a need for more visual aids related to the LR-TR system. Multiple respondents requested additional clarity within the LR-TR algorithm regarding the evolution of post-treatment radiation changes over time. Conclusion: Most survey participants use the LR-TR algorithm after locoregional therapy for HCC. Future iterations of the algorithm may benefit from increased clarity regarding response after radiation-based therapies. Educational materials should include more visual aids to improve reader understanding. [ABSTRACT FROM AUTHOR]

To characterise formal mentorship programmes in Canadian radiology residency programmes, to evaluate residents' perspectives on formal mentorship, and to identify ways to optimise mentorship during radiology training. An anonymous survey was distributed to radiology resident representatives of the Canadian Association of Radiologists (CAR) Resident and Fellow Section (RFS). Questions pertained to the presence and structure of formal mentorship programmes at each participant's institution. The survey was distributed to 33 radiology residents, of which 30 responded. All 16 accredited radiology residency programmes in Canada were represented. Of these programmes, 12 (75%) had formal mentorship programmes and four (25%) did not. The structure of formal mentorship programmes varied among institutions including one-on-one and group mentoring. For 33% of residency programmes, the programme director assigned the mentor and mentee groups. Only 33% of respondents had the option of choosing their mentor. Lack of funding and lack of time were the two main perceived barriers by residents to maintaining mentorship relationships. Although not all radiology residency programmes in Canada have a formal mentorship programme, most have a form of structured mentorship in place. As formal mentorship programmes improve overall mentorship experience during residency, they can lead to improved research productivity, fellowship, and career preparation, as well as work–life balance for Canadian radiology residents. • Many Canadian radiology residency programmes have formal mentorship programmes. • Lack of time and funding are main barriers to maintaining mentorship programmes. • Proper planning of mentorship programmes improves residency mentorship experience. [ABSTRACT FROM AUTHOR]

Purpose: To understand the practice and determinants of non-academic radiologists regarding LI-RADS and the four current LI-RADS algorithms: CT/MRI, contrast-enhanced ultrasound (CEUS), ultrasound (US), and CT/MRI Treatment Response. Materials and methods: Seven themes were covered in this international survey, as follows: (1) demographics of participants and sub-specialty, (2) HCC practice and interpretation, (3) reporting practice, (4) screening and surveillance, (5) HCC imaging diagnosis, (6) treatment response, and (7) CT and MRI technique. Results: Of the 232 participants, 69.4% were from the United States, 25.0% from Canada, and 5.6% from other countries and 45.9% were abdominal/body imagers. During their radiology training or fellowship, no formal HCC diagnostic system was used by 48.7% and LI-RADS was used by 44.4% of participants. In their current practice, 73.6% used LI-RADS, 24.7% no formal system, 6.5% UNOS-OPTN, and 1.3% AASLD. Barriers to LI-RADS adoption included lack of familiarity (25.1%), not used by referring clinicians (21.6%), perceived complexity (14.5%), and personal preference (5.3%). The US LI-RADS algorithm was used routinely by 9.9% of respondents and CEUS LI-RADS was used by 3.9% of the respondents. The LI-RADS treatment response algorithm was used by 43.5% of the respondents. 60.9% of respondents thought that webinars/workshops on LI-RADS Technical Recommendations would help them implement these recommendations in their practice. Conclusion: A majority of the non-academic radiologists surveyed use the LI-RADS CT/MR algorithm for HCC diagnosis, while nearly half use the LI-RADS TR algorithm for assessment of treatment response. Less than 10% of the participants routinely use the LI-RADS US and CEUS algorithms. [ABSTRACT FROM AUTHOR]

Introduction: Prior studies on Canadian physicians' income have demonstrated a gender pay gap (GPG); however, there is a paucity of data in the Radiology specialty. A cross-sectional study was conducted to determine if practicing Canadian radiologists' self-reported income is related to gender, controlling for demographic and work variables. Methods: English and French online surveys were distributed by email and social media to radiologists and trainees (May–July 2021). The association between Gender (controlling for Ethnicity variables, Region, having Children, Full-/Part-Time work, and Academic position) and Self-Reported Income was examined using chi-square tests. Pearson correlations examined relationships between opinion variables. Analyses were conducted using SPSS V28.0. A priori significance was P <.05. Study had ethics approval. Results: Four hundred and fifty-four practicing Canadian radiologists responded. Majority were women (51.2%, n = 227), a non-visible Minority (71.7%, n = 317), and from Western Provinces (67.8%, n = 308). Significant relationship was established between Self-Reported Income and Gender (χ2 = 10.44, df = 2, P <.05). More men (70.6%, n = 120) than women (56.4%, n = 110), reported income "greater than $500 000"; fewer men (20.6%, n = 35) than women (35.9%, n = 70) reported "$300 000-$500 000"; a similar percent of men (8.8%, n = 15) and women (7.7%, n = 15) reported "less than $300 000." No relationship was found between self-reported income and gender for ethnicity variables, those without children, part-time, or non-academic radiologists. The opinion "Addressing the GPG is important" correlated to "Canadian Association of Radiologists should collect demographic data" (r = 0.63). Responses were low for ethnic minorities and non-western provinces. Conclusion: Our results suggest a GPG exists in Canadian radiology and is an important first step for future studies. [ABSTRACT FROM AUTHOR]

Background: Comprehensive diagnostic imaging referral guidelines are an important tool to assist referring clinicians and radiologists in determining the safest and best-clinical-value diagnostic imaging study for their patients; the Canadian Association of Radiologists (CAR) last produced its diagnostic imaging referral guidelines in 2012. In partnership with several national organizations, referring clinicians, radiologists, and patient and family advisors from across Canada, the association is redoing its referral guidelines using a new methodology for guideline development, and these guideline recommendations will be suited for integration into clinical decision support systems. Methods: Expert panels of radiologists, referring clinicians and a patient advisor will work with epidemiologists at the CAR to create guidelines across 13 clinical sections. The expert panel for each section will first create a comprehensive list of clinical and diagnostic scenarios to include in the guidelines. Canadian Association of Radiologists epidemiologists will then conduct a systematic rapid scoping review to identify systematically produced guidelines from other guideline groups. The corresponding expert panel will develop diagnostic imaging recommendations for each clinical and diagnostic scenario using the recommendations identified from the scoping review and contextualize them to the Canadian health care systems. The expert panels will accomplish this using an adapted Grading of Recommendations Assessment, Development and Evaluation framework, which reflects the benefits and harms, values and preferences, equity, accessibility, resources and cost. Interpretation: Freely available, up-to-date, comprehensive Canadian-specific diagnostic imaging referral guidelines are needed. A transparent and structured guideline-development approach will aid the CAR and its partners in producing guidelines across its 13 sections. [ABSTRACT FROM AUTHOR]

Burnout is a healthcare concern affecting physicians around the world. Physicians experiencing burnout tend to display signs of emotional exhaustion, depersonalization, and low personal accomplishment. Ongoing burnout trends have posed numerous challenges to Canadian physicians, notwithstanding the added complexity of the COVID-19 pandemic's impact in recent years. In particular, Canadian radiologists frequently reported experiencing high rates of burnout. This review aims to examine prominent factors affecting burnout in Canadian radiologists and summarize the impact of recent trends. In doing so, the overall wellbeing of Canadian radiologists can be assessed, and strategies for improvement can be discussed as the Canadian healthcare system prepares for new challenges of increasing demand and pressures. [ABSTRACT FROM AUTHOR]

Interventional radiologists (IRs) have a massive impact on their patients, communities, and healthcare at large. Yet, IRs have physical and emotional challenges that lead to a high rate of burnout compared with other medical specialties. A Medscape survey in 2013 showed a 37% burnout incidence among radiologists, which increased to 49% in 2015. This ranked radiology 7th out of 26 specialties with respect to burnout. Although the survey did not examine IR specifically, with the increasing demands on those in the profession, this number can only be expected to increase. A survey by Bundy et al demonstrated that interventional radiologists are in the upper range of burnout among physicians with 71.9% presenting with at least 1 manifestation of burnout. This is higher than that reported among surgeons or diagnostic radiologists. We must be proactive in addressing wellness in IR if we are to flourish both individually and as a group. The impact of suboptimal well-being in an IR goes beyond that of the individual, influencing patient care with ripple effects to society at large. At worst, severe burnout can lead to an early exit from medicine, with the cost of recruiting a replacement IR estimated at two to three times an annual physician salary. This is to say nothing of the experience, wisdom, and leadership that are lost when physicians burn out and drop out. Particularly in IR, where the work performed often improves the cost-effectiveness and quality of care, burnout is a threat to the physician workforce and healthcare at large. In this article, our goal is to share some elements of physician well-being and highlight opportunities to support well-being in IR. [ABSTRACT FROM AUTHOR]

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Canadian Association of Radiologists supports equity, diversity, and inclusion (EDI) in employment. It is imperative that institutions implement recruitment and retention practices to ensure a diverse workforce. This requires considerable attention to each step in the process, including the job posting, candidate search, hiring committee composition, interviews, hiring decision, and retention and promotion. Job postings must be widely distributed and visible to underrepresented groups. The candidate search should be completed by a diverse committee with expertise in EDI. All committee members must complete EDI and anti-bias training and conduct a broad search that ensures underrepresented groups are encouraged to apply. Interviews must be offered to all candidates. The hiring decision must avoid the use of subjective criteria. Recruitment of members of underrepresented groups ensures a diverse workforce, and organizations should commit resources to the retention and promotion of these members. Mentorship programs must be implemented and incentives provided to faculty members to serve as mentors. Transparent guidelines for promotion made universally available on department or institution websites. Recruiting a diverse workforce in Medical Imaging will only be achieved if EDI are central to the organization's goals and strategic plan. All organizational policies, practices, and procedures must be reviewed with an intersectional lens to identify potential gaps, areas for improvement, and areas of strength in the recruitment and retention of members of underrepresented groups., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Faisal Khosa is the recipient of the Michael Smith Health Research BC Award (2023-2028). No other disclosures. Andrea D. Doria has had, during the past 3 years, the following relationships unrelated to this work.

The Canadian Association of Radiologists (CAR) Gastrointestinal Expert Panel consists of radiologists, a gastroenterologist, a general surgeon, a family physician, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 20 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 58 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 85 recommendation statements specific to the adult population across the 20 scenarios. This guideline presents the methods of development and the referral recommendations for dysphagia/dyspepsia, acute nonlocalized abdominal pain, chronic abdominal pain, inflammatory bowel disease, acute gastrointestinal bleeding, chronic gastrointestinal bleeding/anemia, abnormal liver biopsy, pancreatitis, anorectal diseases, diarrhea, fecal incontinence, and foreign body ingestion., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Canadian Association of Radiologists (CAR) Head and Neck Expert Panel consists of radiologists, a laryngologist and laryngeal surgeon, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 11 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 17 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 26 recommendation statements across the 11 scenarios. This guideline presents the methods of development and the referral recommendations for sinus disease, tinnitus, thyroid and parathyroid disease, neck mass of unknown origin, acute sialadenitis, chronic salivary conditions, and temporomandibular joint dysfunction., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Canadian Association of Radiologists (CAR) Thoracic Expert Panel consists of radiologists, respirologists, emergency and family physicians, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 24 clinical/diagnostic scenarios, a rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 30 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 48 recommendation statements across the 24 scenarios. This guideline presents the methods of development and the referral recommendations for screening/asymptomatic individuals, non-specific chest pain, hospital admission for non-thoracic conditions, long-term care admission, routine pre-operative imaging, post-interventional chest procedure, upper respiratory tract infection, acute exacerbation of asthma, acute exacerbation of chronic obstructive pulmonary disease, suspect pneumonia, pneumonia follow-up, immunosuppressed patient with respiratory symptoms/febrile neutropenia, chronic cough, suspected pneumothorax (non-traumatic), clinically suspected pleural effusion, hemoptysis, chronic dyspnea of non-cardiovascular origin, suspected interstitial lung disease, incidental lung nodule, suspected mediastinal lesion, suspected mediastinal lymphadenopathy, and elevated diaphragm on chest radiograph., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Canadian Association of Radiologists (CAR) Musculoskeletal System Expert Panel consists of musculoskeletal radiologists, a family physician, a sports and exercise medicine physician, emergency medicine physicians, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 25 musculoskeletal clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for 1 or more of these clinical/diagnostic scenarios. Recommendations from 41 guidelines (50 publications) and contextualization criteria in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for guidelines framework were used to develop 124 recommendation statements across the 25 scenarios related to the evaluation of the musculoskeletal system. This guideline presents the methods of development and the recommendations for imaging in the context of musculoskeletal pain, infection, tumors, arthropathies, metabolic bone disease, stress injuries, orthopedic hardware, avascular necrosis/bone infarction, and complex regional pain syndrome., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: The availability of same-day services in breast imaging is an important topic given potential advantages for timely diagnoses and patient experiences, but there are potential barriers that lead facilities to not offer these services. We sought to understand current practice patterns and radiologist perspectives on offering same-day services., Methods: The Society of Breast Imaging (SBI) Patient Care & Delivery Committee developed a 19-question survey that was emailed to all 3449 active members of the SBI in May 2023. An exemption from the institutional review board was obtained at the lead author's institution. The survey consisted of 19 questions that were designed to understand the scope, perceptions, barriers, and logistics of same-day services. Comparisons were made between responses for offering same-day services (screening interpretation, diagnostic examinations, biopsies) and respondent demographics., Results: A total of 437 American and Canadian members participated, yielding a response rate of 12.7%. Respondents were most commonly in private practice (43.0%, 188/437), working in an outpatient medical center-based clinic (41.9%, 183/437), and without trainees (64.5%, 282/437). Respondents estimated 12.1% of screening examinations were interpreted while patients waited, which was significantly more common in free-standing breast imaging clinics (P = .028) and practices without trainees (P = .036). Respondents estimated 15.0% of diagnostic examinations were performed same day, which was more common in academic and private practices (P = .03) and practices without trainees (P = .01). Respondents estimated 11.5% of biopsies were performed the same day as the recommendation, which had no association with practice type/context, presence of trainees, number of mammography units, number of radiologists, or number of technologists. Long patient travel distance and limited patient mobility were the most cited reasons for offering patients same-day services., Conclusion: Offering same-day breast imaging services varies among institutions and may be influenced by factors such as practice context and type and the presence of trainees., (© Society of Breast Imaging 2024. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The use of point-of-care ultrasound (POCUS) in the perioperative setting by the anesthesiologists has now become a new demand. It has been proven to improve the patient outcome and to guide clinical management in critical situations. The anesthesiologists are still struggling to obtain POCUS skills and become POCUS competent. In Canada, many institutions have started to integrate POCUS into their anesthesiology training programs to build up a new generation of POCUS trained anesthesiologists. However, it's important to remember that POCUS is very different from the formal ultrasound examination done by the radiologists. This editorial defines the benefits of POCUS to anesthesia practice and offers strategies to help integrate POCUS into the routine anesthesia training programs. [ABSTRACT FROM AUTHOR]

Objective: To determine burnout prevalence in Canadian radiology residency and identify contributing factors. Materials and Methods: A prospective 57-item survey, including the 22-item Maslach Burnout Inventory-Health Sciences Survey, was sent to all Canadian radiology residents, with a total resident population of 359. The association between emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA) scores with items in the survey was performed. Continuous data were evaluated using the Student t test for comparing the means between the 2 groups or the analysis of variance test for comparing the means between at least 3 groups. Spearman correlation coefficient was performed when evaluating ordinal categorical data. Results: Response rate is 40.1% (n = 144); 50.7% of residents demonstrate high EE, 48.6% demonstrate high DP, and 35.9% demonstrate low PA. Being unhappy with residency and with radiology as a career is associated with burnout (P <.001). Age, sex, marital status, and children have no impact on burnout. More hours worked is associated with higher EE (P =.025) and DP (P =.004). In all, 47.2% residents experienced intimidation or harassment. Feeling unsupported by staff radiologists is associated with higher EE (P <.001), higher DP (P =.001), and lower PA (P =.008). In all, 45.1% of residents have poor work–life balance, and those residents demonstrate higher EE (P <.001), higher DP (P =.006), and lower PA (P =.01). In all, 25% of residents identify poor education-service balance in their residency, and those residents have higher EE (P <.001), higher DP (P =.042), and lower PA (P =.005). Conclusion: This study demonstrates significant burnout in Canadian radiology residents with major contributory factors identified. [ABSTRACT FROM AUTHOR]

Colon cancer is the third most common malignancy in Canada. Computed tomography colonography (CTC) provides a creditable and validated option for colon screening and assessment of known pathology in patients for whom conventional colonoscopy is contraindicated or where patients self-select to use imaging as their primary modality for initial colonic assessment. This updated guideline aims to provide a toolkit for both experienced imagers (and technologists) and for those considering launching this examination in their practice. There is guidance for reporting, optimal exam preparation, tips for problem solving to attain high quality examinations in challenging scenarios as well as suggestions for ongoing maintenance of competence. We also provide insight into the role of artificial intelligence and the utility of CTC in tumour staging of colorectal cancer. The appendices provide more detailed guidance into bowel preparation and reporting templates as well as useful information on polyp stratification and management strategies. Reading this guideline should equip the reader with the knowledge base to perform colonography but also provide an unbiased overview of its role in colon screening compared with other screening options., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Artificial intelligence (AI) software that analyzes medical images is becoming increasingly prevalent. Unlike earlier generations of AI software, which relied on expert knowledge to identify imaging features, machine learning approaches automatically learn to recognize these features. However, the promise of accurate personalized medicine can only be fulfilled with access to large quantities of medical data from patients. This data could be used for purposes such as predicting disease, diagnosis, treatment optimization, and prognostication. Radiology is positioned to lead development and implementation of AI algorithms and to manage the associated ethical and legal challenges. This white paper from the Canadian Association of Radiologists provides a framework for study of the legal and ethical issues related to AI in medical imaging, related to patient data (privacy, confidentiality, ownership, and sharing); algorithms (levels of autonomy, liability, and jurisprudence); practice (best practices and current legal framework); and finally, opportunities in AI from the perspective of a universal health care system. [ABSTRACT FROM AUTHOR]

Objective: To examine differences in fee-for-service (FFS) payments to men and women radiologists in Canada and evaluate potential contributors. Methods: Publicly available FFS radiology billing data was analyzed from British Columbia (BC), Ontario (ON), Prince-Edward Island (PEI) and Nova Scotia (NS) between 2017 and 2021. Data was analyzed by gender on a per-province and national level. Variables evaluated included year, province, procedure billings, and days worked (BC and ON only). The gender pay gap was expressed as the difference in mean billing payments between men and women divided by mean payments to men. Results: Data points from 8478 radiologist years were included (2474 [29%] women and 6004 [71%] men). The unadjusted difference in annual FFS billings between men and women was $126,657. Overall, payments to women were 81% of payments to men with a 19% gender pay gap. The difference in billings between men and women did not change significantly between 2017 and 2021 (range in gender pay gap, 17-21%) but did vary by province (highest gap NS). Compared to men, women worked fewer days per year (weighted mean 218 ± 29 vs 236 ± 25 days/year, P < .001, 8% difference). Conclusion: In an analysis of fee-for-service payments to radiologists in 4 Canadian provinces between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap. Payments were lower to women across all years evaluated. Women worked 8% fewer days per year on average than men, which did not fully account for the difference in FFS billing payments between men and women. Summary Statement: In an analysis of fee-for-service payments to Canadian radiologists between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap which is not fully accounted for by time spent working., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Abstract Purpose Acute radiologic emergencies, primarily severe contrast reactions, are rare but life-threatening events. Given a generalized paucity of formalized or mandated training, studies have shown that radiologists and trainees perform poorly when acutely managing such events. Moreover, skill base, knowledge, and comfort levels precipitously decline over time given the infrequent occurrence of these events during one's daily practice. The primary aim of this study was to assess radiologists' preparedness for managing acute radiologic emergencies and to determine the efficacy of a high-fidelity simulation based training model in an effort to provide a rationale for similar programs to be implemented on a provincial or national level. Methods This was a prospective, observational study of radiology residents and attending radiologists throughout the province who were recruited to attend a full-day simulation-based course presenting various cases of acute radiologic emergencies. Participant demographics were collected at the time of commencement of the workshop. Course materials were disseminated 4 weeks prior to the workshop, and a 17-question knowledge quiz was administered before and after the workshop. Likert-type questionnaires were also distributed to survey comfort levels and equipment familiarity. The knowledge quiz and questionnaire were redistributed at 3- and 6-month intervals for acquisition of follow-up data. Results A total of 14 attending radiologists and 7 residents attended the workshop, with all participants completing the preworkshop questionnaire and 90.5% (19 of 21) completing the post-workshop questionnaire. Participants' principle locations of practice were as follows: academic institutions (50%), community hospitals (36.9%), and private clinics (13.1%). A significant increase in knowledge was demonstrated, with average scores of 10 out of 17 (59%) and 14.5 out of 17 (85%) (P <.001) before and after the workshop, respectively. A significant increase in participants' comfort levels in recognizing acute anaphylactic reactions (3.5; 4.7, P <.001), commencing initial management for acute radiologic emergencies (3.3; 5.0, P <.001), and administering the correct dose for anaphylactic reactions (2.5; 4.8, P <.001) was also demonstrated. Moreover, participants became increasingly familiar with the contents and equipment found within contrast reaction kits (2.8; 3.8, P <.01). Repeat evaluations at 3 and 6 months found an average knowledge test score of 13.8 out of 17 (81%) and 10.8 out of 17 (64%), respectively. Comfort levels were also reassessed in recognizing acute anaphylactic reactions (4.5; 4.1), commencing initial management (4.0; 3.9) and administering the correct dose of medication (4.0; 3.7) at 3- and 6-month intervals. Conclusions Acute radiologic emergencies are rare but life-threatening events that require rapid diagnosis and treatment to mitigate associated morbidity and mortality. Simulation-based workshops are a highly efficacious training model to increase knowledge, comfort levels, and equipment familiarity for radiologists and trainees alike; however, retraining at regular intervals is required. [ABSTRACT FROM AUTHOR]

Abstract Purpose Physician burnout is on the rise compared to the average population, and radiology burnout rates are ranked high compared to other specialties. We aim to assess radiologist and radiology trainee burnout in Canada. Methods A survey using the abbreviated 7-item Maslach Burnout Inventory that characterizes burnout symptoms into personal accomplishment, emotional exhaustion, and depersonalization was sent to all eligible members of the Canadian Association of Radiologists in January 2018. The anonymous survey was hosted on SurveyMonkey for 1 month. A reminder e-mail was sent halfway through the survey period. Results Overall, 262 of 1401 invited radiology trainees and radiologists completed the survey (response rate 18.7%). With regards to personal accomplishment, we observed that (1) burnout in this domain improved with increased years worked and (2) milder symptoms were observed in community radiologists compared with their academic counterparts. In comparison with other studies of radiologist burnout, we found mild burnout symptoms in personal accomplishment, but severe symptoms in the burnout domains of both emotional exhaustion and depersonalization. Conclusions Canadian radiologists and radiology trainees reported above average burnout symptoms with regard to both emotional exhaustion and depersonalization. Future research directions include exploring etiologies of burnout and implementation of treatment strategies based on these identified problem areas. [ABSTRACT FROM AUTHOR]

Purpose: European data suggest that 8-fraction stereotactic body radiation therapy (SBRT) regimens may be similar in efficacy with less toxicity than ≤5-fraction SBRT for central lung lesions. However, under current Centers for Medicare and Medicaid Services guidelines, SBRT in the United States (US) is reimbursed for only ≤5 fractions, whereas there are no such restrictions for reimbursement in Canada. We hypothesize that US-specific SBRT reimbursement policies influence the use of ≥5-fraction SBRT in US academic centers in comparison with comparable Canadian centers.Methods and Materials: A 15-question electronic survey was distributed to radiation oncologists at National Cancer Institute-designated cancer centers in the US and the 10 highest research-funded cancer centers in Canada. Fisher exact test or exact logistic regression if applicable was used, where P<.05 was considered statistically different from neutral.Results: Of the 143 radiation oncologists from 60 US cancer centers and 6 Canadian cancer centers who completed the survey (17.6% response rate), 125 routinely prescribe SBRT. Fifty percent of US physicians versus 0% of Canadian physicians indicated that there are instances when they would like to prescribe >5-fraction SBRT but prescribe ≤5 fractions because of insurance reimbursement (P=.076 and P=.001, respectively). Seventy percent (P=.006) of US radiation oncologists versus 0% (P=.001) of Canadian radiation oncologists report that SBRT clinical investigation is constrained by the insurance reimbursement. The most common reported deterrent to prescribing >5-fraction SBRT in the US was insurance reimbursement (49.5%).Conclusions: US radiation oncologists are more likely than those in Canada to report that SBRT clinical investigation and >5-fraction SBRT use may be negatively influenced by health insurance reimbursement; this perception was not held by physicians in Canada. Health care environment may significantly affect radiation therapy decision making and practice patterns. [ABSTRACT FROM AUTHOR]

Purpose The study sought to determine screening mammography recommendations that radiologists in Canada promote to average-risk patients and family or friends, and do or would do for themselves. Methods An online survey was delivered from February 19, 2014, to July 11, 2014. Data included radiologists' recommendations for mammography and their personal screening habits based on gender. The 3 radiologists' cohorts were women ≥40 years of age, women <40 years of age, and men. The distribution of responses for each question was summarized, and proportions for the entire group and individual cohorts were computed. Results Of 402 surveys collected, 97% (299 of 309) radiologists recommended screening every 1-2 years, 62% (192 of 309) starting ≥40 years of age and 2% (5 of 309) recommended screening every 2-3 years for women 50-74 years of age. Recommendations were similar for family and friends: 96% (294 of 305) recommended screening every 1-2 years, 66% (202 of 305) recommended screening every 1-2 years for women ≥40 years of age, and 2% (5 of 305) recommended screening every 2-3 years. For women radiologists ≥40 years of age, 76% (48 of 63) underwent screening every 1-2 years and started at 40 years of age, 76% (16 of 21) female radiologists <40 years of age would undergo screening ≥40 years of age, 100% every 1-2 years, and 90% (151 of 167) male radiologists would undergo screening every 1-2 years, with 71% (120 of 169) beginning at 40 years of age. Conclusion The majority of Canadian radiologists recommend screening mammography every 1-2 years for average-risk women ≥40 years of age, whether they are patients or family and friends. [ABSTRACT FROM AUTHOR]

The Canadian Association of Radiologists (CAR) Incidental Findings Working Group consists of both academic subspeciality and general radiologists tasked with either adapting American College of Radiology (ACR) guidelines to meet the needs of Canadian radiologists or authoring new guidelines where appropriate. In this case, entirely new guidelines to deal with incidental musculoskeletal findings that may be encountered on thoracoabdominal computed tomography or magnetic resonance imaging were drafted, focussing on which findings should prompt recommendations for further workup. These recommendations discuss how to deal with incidental marrow changes, focal bone lesions, abnormalities of the pubic symphysis and sacroiliac joints, fatty soft tissue masses, manifestations of renal osteodystrophy and finally discuss opportunistic osteoporosis evaluation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Thoracic interventions are frequently performed by radiologists, but guidelines on appropriateness criteria and technical considerations to ensure patient safety regarding such interventions is lacking. These guidelines, developed by the Canadian Association of Radiologists, Canadian Association for Interventional Radiology and Canadian Society of Thoracic Radiology focus on the interventions commonly performed by thoracic radiologists. They provide evidence-based recommendations and expert consensus informed best practices for patient preparation; biopsies of the lung, mediastinum, pleura and chest wall; thoracentesis; pre-operative lung nodule localization; and potential complications and their management.

Artificial intelligence (AI) software in radiology is becoming increasingly prevalent and performance is improving rapidly with new applications for given use cases being developed continuously, oftentimes with development and validation occurring in parallel. Several guidelines have provided reporting standards for publications of AI-based research in medicine and radiology. Yet, there is an unmet need for recommendations on the assessment of AI software before adoption and after commercialization. As the radiology AI ecosystem continues to grow and mature, a formalization of system assessment and evaluation is paramount to ensure patient safety, relevance and support to clinical workflows, and optimal allocation of limited AI development and validation resources before broader implementation into clinical practice. To fulfil these needs, we provide a glossary for AI software types, use cases and roles within the clinical workflow; list healthcare needs, key performance indicators and required information about software prior to assessment; and lay out examples of software performance metrics per software category. This conceptual framework is intended to streamline communication with the AI software industry and provide healthcare decision makers and radiologists with tools to assess the potential use of these software. The proposed software evaluation framework lays the foundation for a radiologist-led prospective validation network of radiology AI software. Learning Points: The rapid expansion of AI applications in radiology requires standardization of AI software specification, classification, and evaluation. The Canadian Association of Radiologists' AI Tech & Apps Working Group Proposes an AI Specification document format and supports the implementation of a clinical expert evaluation process for Radiology AI software.

Breast density notification laws, passed in 19 states as of October 2014, mandate that patients be informed of their breast density. The purpose of this study is to assess the impact of this legislation on radiology practices, including performance of breast cancer risk assessment and supplemental screening studies. A 20-question anonymous web-based survey was emailed to radiologists in the Society of Breast Imaging between August 2013 and March 2014. Statistical analysis was performed using Fisher's exact test. Around 121 radiologists from 110 facilities in 34 USA states and 1 Canadian site responded. About 50% (55/110) of facilities had breast density legislation, 36% of facilities (39/109) performed breast cancer risk assessment (one facility did not respond). Risk assessment was performed as a new task in response to density legislation in 40% (6/15) of facilities in states with notification laws. However, there was no significant difference in performing risk assessment between facilities in states with a law and those without (p < 0.831). In anticipation of breast density legislation, 33% (16/48), 6% (3/48), and 6% (3/48) of facilities in states with laws implemented handheld whole breast ultrasound ( WBUS), automated WBUS, and tomosynthesis, respectively. The ratio of facilities offering handheld WBUS was significantly higher in states with a law than in states without (p < 0.001). In response to breast density legislation, more than 33% of facilities are offering supplemental screening with WBUS and tomosynthesis, and many are performing formal risk assessment for determining patient management. [ABSTRACT FROM AUTHOR]

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Improving equity, diversity, and inclusion (EDI) within Canadian radiology is critical for optimal patient care and to reduce health disparities. Although there are increasing national EDI initiatives, there is a paucity of resources available to assist radiology departments as the culture of EDI evolves and faculty and institutions are expected to incorporate EDI in their practice. We present practical recommendations for radiology departments, radiology training programs, and individual radiologists wishing or mandated to improve EDI in the workplace. Actionable strategies for creating an environment that promotes EDI, attracting and supporting diverse trainees, and for how individual radiologists can be allies are presented. These EDI strategies are imperative to provide the best patient care and to strengthen the future of Canadian radiology.

Rationale and Objectives: A goal in radiology undergraduate medical education is to improve exposure to the field. In 2022, the Canadian Association of Radiologists' Medical Student Network hosted for the first time "RADGames," an interactive image interpretation contest for medical students across Canada. This program was aimed to spark interest in radiology and improve students' image interpretation skills through gamification with expert guidance., Materials and Methods: Volunteers from Radiology Interest Groups in Canadian medical schools set up a virtual event for the competition using breakout rooms and a quiz platform. Participant recruitment was through social media and advertisement by medical student associations. Participants were surveyed anonymously for feedback following the event. Data about previous exposure to and knowledge of radiology, and an evaluation of the event including self-perceived impact on participants' understanding of the field were collected., Results: Eighty seven medical students from 15 of Canada's 17 medical schools competed against one another virtually. Forty seven (54%) responded to the post-event evaluation survey. All responses about the event itself were favourable. Respondents overwhelmingly indicated that RADGames increased their interest in radiology (38, 81%), their understanding of the work of a radiologist (31, 66%) and their knowledge about medical imaging (46, 98%), and improved their confidence in basic imaging interpretation (36, 77%)., Conclusion: The Canadian Association of Radiologists' Medical Student Network hosted Canada's first national image interpretation competition for medical students, RADGames. Feedback was overwhelmingly positive, with perceived benefits to participants on their understanding of and interest in radiology., (Copyright © 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Purpose: To determine the percentage of abstracts presented at the Canadian Association of Radiologists (CAR) annual scientific meetings that go on to publication. Methods: Records of previous CAR meetings from the years 2005-2011 were obtained. An Internet search was performed to determine which abstracts went on to publication. Abstracts were assessed according to exhibit category (Resident Award Papers), educational institution, publishing journal, and time to publication. Results: Of the 402 abstracts presented, 112 (28%) were published. Overall, an average of 37% of Radiologists-In-Training Presentations, 34% of Scientific Exhibits, and 20% of Educational Exhibits went on to publication. The University of British Columbia and University of Ottawa published the largest number of abstracts (66 and 62, respectively) from the years 2005-2011. The University of Montreal had the largest percentage of abstracts published (42%). The range of publishing journals was wide, but the top publisher was the Canadian Association of Radiologists Journal (27%). Eighty-three percent of abstracts were published within 3 years of being presented. Conclusion: In total, 28% of all the abstracts presented at the CAR conferences between 2005 and 2011 were published. Further exploration into the reasons and barriers for abstracts not being published may be a next step in future research. [ABSTRACT FROM AUTHOR]

Oral and maxillofacial radiology is the newest specialty to be recognized by the American Dental Association, so knowledge about the parameters of this profession is in the early stages of development. The aim of this study was to understand the current distribution of oral and maxillofacial radiologists (OMFRs) in academia and private practice, the nature of their practice, and trends in their board certification status. An email describing the study's purpose with a link to a survey was sent to "OradList," a listserv that has a majority of OMFRs in the United States and Canada as members. Of the 205 respondents, 46% were female; the age distribution ranged from 25 to over 70 years; and 80% were working full-time. Among the respondents, 66% practiced in an academic setting, 20% in private practice, 8% in both private and academic settings, and 3% in the military. Only 37% of the respondents were board-certified. For OMFRs trained from 1965 to 2009, there was an increasing trend towards becoming boardcertified, but a significant decrease occurred after 2009, dropping from 65% to 35% of those trained in those years. [ABSTRACT FROM AUTHOR]

Purpose: To develop a tool for the external and self-evaluation of residents in the Communicator, Collaborator, and Professional Can MEDS roles. Methods: An academic teaching institution affiliated with 4 major urban hospitals conducted a survey that involved 46 residents and 216 hospital staff members. Residents selected at least 13 external evaluators from different categories (including physicians, nurses or technologists, peers or fellows, and support staff members) from their last 6 months of rotations. The external evaluators and residents answered 4 questions that pertained to each of the 3 Can MEDS roles being assessed. The survey results were analysed for feasibility, variance within and between rater groups, and the relationships between multisource and self-evaluation scores, and between multisource feedback and intraining evaluation report scores. Results: The multisource feedback survey had an overall response rate of 73% with 683 evaluations sent out to 216 unique evaluators. The ratings from different groups of evaluators were only weakly correlated. Residents were most likely to receive their best rating from a collaborating physician and their worst rating from a site secretary or a program assistant. Generally, self-assessment scores were significantly lower than multisource feedback scores. Although there was a strong correlation within the multisource feedback data and within the in-training evaluation report data, there was a weak correlation among the data sets. Conclusions: Multisource feedback provides useful feedback and scores that relate to critical Can MEDS roles that are not necessarily reflected in a resident's in-training evaluation report. The self-assessment feature of multisource feedback permits a resident to compare the accuracy of his or her assessments to improve their life-long learning skills. [ABSTRACT FROM AUTHOR]

Emergency Radiology is a clinical practice and an academic discipline that has rapidly gained increasing global recognition among radiology and emergency/critical care departments and trauma services around the world. As with other subspecialties, Emergency Radiology practice has a unique scope and purpose and presents with its own unique challenges. There are several advantages of having a dedicated Emergency Radiology section, perhaps most important of which is the broad clinical skillset that Emergency Radiologists are known for. This multi-society paper, representing the views of Emergency Radiology societies in Canada and Europe, outlines several value-oriented contributions of Emergency Radiologists and briefly discusses the current state of Emergency Radiology as a subspecialty.

Prostate cancer is the most common malignancy and the third most common cause of death in Canadian men. In light of evolving diagnostic pathways for prostate cancer and the increased use of MRI, which now includes its use in men prior to biopsy, the Canadian Association of Radiologists established a Prostate MRI Working Group to produce a white paper to provide recommendations on establishing and maintaining a Prostate MRI Programme in the context of the Canadian healthcare system. The recommendations, which are based on available scientific evidence and/or expert consensus, are intended to maintain quality in image acquisition, interpretation, reporting and targeted biopsy to ensure optimal patient care. The paper covers technique, reporting, quality assurance and targeted biopsy considerations and includes appendices detailing suggested reporting templates, quality assessment tools and sample image acquisition protocols relevant to the Canadian healthcare context.

Fracture risk calculators may not be accurate for all ethnicity groups. The Manitoba bone density registry was used to test the Canadian CAROC tool for predicting fracture risk in Asian-Canadian women. The tool significantly over-estimated fracture risk, suggesting that it may not be ideal for Asian-Canadian patients., Purpose: Health risk prediction tools based on largely White populations may lead to treatment inequity when applied to non-White populations where outcome rates differ. We examined the calibration of the Canadian Association of Radiologists-Osteoporosis Canada (CAROC) fracture risk prediction tool in self-identified Asian-Canadian women., Methods: Retrospective cohort study of women over age 50 using the Manitoba BMD Registry. At first BMD, the intake questionnaire collected self-identification of ethnicity and fracture risk factors. 10-year fracture risk was estimated using CAROC and categorized into low, medium, or high fracture risk. Linked administrative databases identified incident osteoporotic fractures. Observed fracture rates were compared between White and Asian-Canadians and compared to the original CAROC risk stratification., Results: There were 63,632 and 1703 women who self-identified as White-Canadian or Asian-Canadian, respectively, covering approximately 600,000 patient-years follow-up. There were 6588 incident fractures; a similar percentage of patients were assigned to each risk stratum at baseline by CAROC. A progressive rise in 10-year observed fracture rates occurred for each CAROC stratum in the White-Canadian population but much lower fracture rates than predicted in Asian-Canadian patients (p &lt; 0.001). Fracture incidence rate ratios were 1.9-2.6 fold higher in White- vs Asian-Canadian patients for all strata (p &lt; 0.001). In the CAROC moderate and high-risk categories, observed fracture rates in Asian-Canadian patients were typically lower than predicted, indicating poor model calibration., Conclusion: In Asian-Canadian women, observed osteoporosis fracture rates are lower than predicted when using the CAROC tool. Over-estimation of fracture risk may influence shared decision-making discussions., (© 2022. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)

Purpose: To assess the percentage, type, and location of radiology fellowships chosen by graduating Canadian residents between 2009 and 2011. Methods: A short e-mail questionnaire was sent to the radiology program directors at all 16 institutions in Canada that provide English or French residency. The responses were collected between December 6, 2010, and May 20, 2011. Results: A 75% response rate was observed for the survey: 76% - 79% residents were enrolled in radiology fellowship training. In 2009 - 2010, 72% - 73% of residents remained in Canada. This dropped to 51% in 2011. In 2009 - 2010, 22% - 23% of residents chose U.S.-based radiology training. This rose to 49% in 2011. Europe was chosen by 0% - 4% of residents: all of whom were French-speaking residents, and all programs were in France. Relatively consistent percentages of radiology residents choose abdominal (19% - 30%), cardiac (4% - 7%), musculoskeletal (12% - 20%), and pediatrics (2% - 5%) from year to year. Greater variability was noted in chest (2% - 9%), women's imaging (0% - 14%), intervention radiology (6% - 18%), and neuroradiology (2% - 18%). Radiology fellowships in split subspecialties, which were available at a small number of institutions, were chosen by 8%-9% of the residents. Conclusions: Nearly 4 of 5 residents choose radiology fellowship training. In 2011, there was a 2-fold increase in the number of residents who chose training in the United States. This may be a 1-year outlier but should be observed. A wide range of fellowships were chosen, with consistent numbers in some core fellowships and variability in others year to year. Limited exploration of the rationale for, or employability value of, radiology fellowship choices has been done in Canada. Nearly 1 of 10 residents chose split radiology fellowships, an option limited by availability at few centers. The value of expanding this option is worthy of investigation. [ABSTRACT FROM AUTHOR]

The article focuses on the radiation units and use of computed topography dose indicators in Canada. It mentions that radiation play a vital role in healthcare. It states that ionizing radiation can damage tissue and can be recognized by international bodies as carcinogen. It states that the direct tissue damage refers to the deterministic effect of radiation.

In June 2008, the Canadian Association of Radiologists published its Standards for Irreversible Compression in Digital Diagnostic Imaging within Radiology (Canadian Association of Radiologists ). The study suggested that at low levels of compression there was no difference in diagnostic accuracy between uncompressed JPEG and JPEG 2000. There were two exceptions; CT neurological and CT body images resulted in lower rating of image quality (Koff et al., J Digit Imaging 22(6):569-78, ). The slice thicknesses used in the previous study were greater than 5 mm. However, other studies (Ringl et al., Radiology 240:869-87, ) suggest that thin CT slices might modify image tolerance to irreversible compression. Therefore, a new clinical evaluation using CT slices less than 3 mm was initiated. We examined CT images in four body regions (chest, body, musculoskeletal, and neurological). Twenty-five radiologists from across Canada participated. Each read a total of 70 CTs in his specialty; 10 at each of seven levels of compression (uncompressed, JPEG and JPEG 2000 at low, medium, and high compression (varying by region)). Each reader diagnosed the case, rated his confidence, and compared the compressed to the uncompressed image and rated the degree of degradation. Data were analyzed for sensitivity, specificity, accuracy, confidence, and degradation at three levels and two types of compression as well as the original image. There were no overall differences in sensitivity, specificity, accuracy, or confidence. JPEG images, at all levels of compression, were rated lower in terms of perceived difference (4.16/5 vs. 4.53/5 for JPEG 2000 and 4.68/5 for uncompressed). However, the rating of perceived difference was not significantly correlated with accuracy. Analysis of individual body regions did not reveal any systematic effects of compression in any region. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: In this qualitative case study involving five academic Radiology centres across Canada, the authors seek to identify the hidden curriculum. Methods: A qualitative case study methodology was used for its potential to explore and provide rich descriptions and allow for the in-depth analysis of multiple data sources that include official institutional documents, surveys, observations and interviews (including undergraduate students, postgraduate, radiologists, imaging scientists, residents, faculty and administrators). This study relied on 48 interviews and involved primary data analysis by the core research team, and a secondary analysis by external examiners. Results: The results revealed that in four of the five major centres studied, a hidden curriculum of isolation prevailed, reinforcing an image of the radiologist as an independent operator within an organization dependent upon collaboration for optimal performance. The fifth site exhibited a hidden curriculum of collaboration and support, although the messages received were conflicting when addressing issues around teaching. Conclusions: The authors conclude by noting two possibilities for medical imaging departments to consider that of isolation or that of integration. They examine the implications of each and propose a way forward that situates Radiology as the crossroads of medicine. As such, the need for a new, generative metaphor reasserts the importance of recognizing the role and function of scholarship in teaching and learning contexts across Canada. [Copyright &y& Elsevier]

Iodinated contrast media (ICM) is one of the most frequently administered pharmaceuticals. In Canada, over 5.4 million computed tomography (CT) examinations were performed in 2019, of which 50% were contrast enhanced. Acute kidney injury (AKI) occurring after ICM administration was historically considered a common iatrogenic complication which was managed by screening patients, prophylactic strategies, and follow up evaluation of renal function. The Canadian Association of Radiologists (CAR) initially published guidelines on the prevention of contrast induced nephropathy in 2007, with an update in 2012. However, new developments in the field have led to the availability of safer contrast agents and changes in clinical practice, prompting a complete revision of the earlier recommendations. This revised guidance document was developed by a multidisciplinary CAR Working Group of radiologists and nephrologists, and summarizes changes in practice related to contrast administration, screening, and risk stratification since the last guideline. It reviews the scientific evidence for contrast associated AKI and provides consensus-based recommendations for its prevention and management in the Canadian healthcare context. This article is a joint publication in the Canadian Association of Radiologists Journal and Canadian Journal of Kidney Health and Disease, intended to inform both communities of practice.

Objective: Determine how many radiology resident research day projects are presented at the Canadian Association of Radiologists Annual Scientific Meeting (CAR ASM) and if presentation at the CAR ASM is associated with increased rates of publication. Methods: A database of radiology resident presentations from 2012 to 2017 research days at seven Canadian radiology programs was utilized. Each presenting resident was searched for in 2011-2019 CAR ASM books of abstracts to identify all CAR ASM presentations both related to and separate from their research day projects. These presentations were matched with resident research day presentations and their publication status. Descriptive statistical analysis and calculation of relative risk (RR) between publication of research day projects and presentation at CAR was performed. Results: 208 residents presented 288 projects at internal research days. 93 of the 208 residents had a total of 195 presentations at CAR (mean .94 +/- 1.91 SD). 36 of the 288 (13%) research day projects were presented at a CAR ASM, of which 18/36 (50%) were published. 83 of the 252 (32%) research day projects not presented at CAR were published. CAR ASM presentation of a research day project was associated with an increased rate of publication (RR 1.537 P=.0396). There was no significant association between research day project publication and unrelated CAR ASM presentations (P=.275). Most research day projects both presented at CAR ASM and published (56%) were in the Canadian Association of Radiologists Journal. Conclusion: CAR ASM presentation of research day projects is associated with an increased rate of publication.

Abstract: Gallbladder polyps (GPs) are a common incidental finding on ultrasound; however, important differences in recommended management exist among professional society guidelines.An electronic survey was sent to 189 fellows of the Society of Radiologists in Ultrasound. Main outcomes included preferences and current practice patterns for evaluation, management, and surveillance of GPs as well as personal lifetime experience with gallbladder sonography and GPs.A total of 64 subjects (34%) with experience in gallbladder sonography completed the study. The estimated combined total number of gallbladder scans seen by the responders was 3,071,880. None of fellows had ever seen a pedunculated GP <1 cm detected on ultrasound that was proven to be malignant at the time of detection or during subsequent follow-up. All of the fellows used size as a feature to stratify recommendations. The median size threshold currently used by Society of Radiologists in Ultrasound fellows for recommending ultrasound follow-up was 6 mm, and their preferred threshold was 7 mm. The median size threshold for recommending surgical consultation was 10 mm, and the preferred threshold was 10 mm. Wall thickening and shape were considered important factors by 76% and 67% of respondents, respectively.Society of Radiologists in Ultrasound fellows tend to provide recommendations most similar to the American College of Radiology and Canadian Association of Radiology guidelines for management of GPs. Many would prefer guidelines that result in fewer recommendations for follow-up and surgical consultation. Despite a substantial combined experience, this survey did not uncover any case of a small GP that was malignant., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)