BackgroundPerfusion‐weighted (Qw) noncontrast‐enhanced proton lung MRI is a promising technique for assessment of pulmonary perfusion, but still requires validation.PurposeTo improve perfusion‐weighted phase‐resolved functional lung (PREFUL)‐MRI, to validate PREFUL with perfusion single photon emission computed tomography (SPECT) as a gold standard, and to compare PREFUL with dynamic contrast‐enhanced (DCE)‐MRI as a reference.Study TypeRetrospective.PopulationTwenty patients with chronic obstructive pulmonary disease (COPD), 14 patients with cystic fibrosis (CF), and 21 patients with chronic thromboembolic pulmonary hypertension (CTEPH) were included.Field Strength/SequenceFor PREFUL‐MRI, a spoiled gradient echo sequence and for DCE‐MRI a 3D time‐resolved angiography with stochastic trajectories sequence were used at 1.5T.AssessmentPREFUL‐MRI coronal slices were acquired in free‐breathing. DCE‐MRI was performed in breath‐hold with injection of 0.03 mmol/kg bodyweight of gadoteric acid at a rate of 4 cc/s. Perfusion SPECT images were obtained for six CTEPH patients. Images were coregistered. An algorithm to define the appropriate PREFUL perfusion phase was developed using perfusion SPECT data. Perfusion defect percentages (QDP) and Qw‐values were calculated for all methods. For PREFUL quantitative perfusion values (PREFULQ) and for DCE pulmonary blood flow (PBF) was calculated.Statistical TestsObtained parameters were assessed using Pearson correlation and Bland–Altman analysis.ResultsQw‐SPECT correlated with Qw‐DCE (r = 0.50, P < 0.01) and Qw‐PREFUL (r = 0.47, P < 0.01). Spatial overlap of QDP maps showed an agreement ≥67.7% comparing SPECT and DCE, ≥64.1% for SPECT and PREFUL, and ≥60.2% comparing DCE and PREFUL. Significant correlations of Qw‐PREFUL and Qw‐DCE were found (COPD: r = 0.79, P < 0.01; CF: r = 0.77, P < 0.01; CTEPH: r = 0.73, P < 0.01). PREFULQ/PBF correlations were similar/lower (CF, CTEPH: P > 0.12; COPD: P < 0.01) compared to Qw‐PREFUL/DCE correlations. PREFULQ‐values were higher/similar compared to PBF‐values (COPD, CF: P < 0.01; CTEPH: P = 0.026).Data ConclusionThe automated PREFUL algorithm may allow for noncontrast‐enhanced pulmonary perfusion assessment in COPD, CF, and CTEPH patients comparable to DCE‐MRI.Level of Evidence 3Technical Efficacy Stage 2J. Magn. Reson. Imaging 2020;52:103–114.
Purpose Good training is the basis for high job satisfaction and high-quality patient care in radiology. The aim of this survey was to record the current state of working conditions for residents in radiology training in Germany and to focus on the aspects of training and psychosocial workload. The description of the actual state should help to identify possible problem areas and to develop improvement approaches.
Materials and Methods At the beginning of 2018, we sent an electronic questionnaire to the German Roentgen Society (DRG), the German Association of Chairmen in Academic Radiology (KLR), the Chief Physician Forum of the DRG (CAFRAD) and the Forum of Registered Radiologists (FUNRAD) with the request to forward it to radiology residents. With 63 questions, the questionnaire covered seven essential areas of medical working and training conditions. In order to ensure interdisciplinary comparability, most questions were identical to previous surveys among residents of other disciplines.
Results 643 residents started the survey. 501 (78 %) questionnaires were fully processed and included in the final analysis. 65 % of respondents were satisfied with their current job situation. At the same time, shortcomings, especially with regard to the reconciliation of family and work as well as scientific and clinical work, became clear. Only 36 % of participants with children were satisfied with the compatibility of family and work at their workplace. Only 31 % of the researchers were satisfied with their research conditions. In addition, residents experienced a high psychosocial workload.
Conclusion Job satisfaction is high among radiology residents in direct comparison to other disciplines. However, based on this survey, adjustments to working conditions and training in radiology seem necessary to maintain the health of the physicians concerned, to encourage motivation for scientific work and to enhance development opportunities, especially for women, through a better compatibility of work and family life. The present survey identifies strategies and leadership tools that can help to achieve this.
Key Points: Residents in radiology training ...
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• CACT guidance of BPA is safe and successful. • CACT-guided BPA procedures have a low complication profile. • CACT guidance is a valuable tool to navigate BPA.
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