Transgender Patients: What Radiologists Need to Know

Sowinski, John; Gunderman, Richard B.

doi:10.2214/ajr.17.18904

Cited by 31 publications

(9 citation statements)

References 28 publications

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“…Where it is agreed that shielding should be used, then staff should be trained in: The selection of appropriate shielding, including how to prevent shielding moving during a procedure due to patient or equipment movement (e.g., during dynamic imaging) The selection of appropriate radiographic techniques, including how to avoid interference with automatic exposure control systems How to perform quality control checks on patient contact shielding How to store shielding appropriately How to clean and disinfect shielding How to comply with local policies regarding patient dignity (e.g., transgender patients [ 39 ]) Communication skills specific to discussions with patients, parents or caretakers of children undergoing radiological examinations and healthcare professionals on the use of patient contact shielding. How to communicate benefit risk to pregnant patients …”

Section: Issues When Using Contact Shieldingmentioning

confidence: 99%

European consensus on patient contact shielding

et al. 2021

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Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.

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Section: Issues When Using Contact Shieldingmentioning

confidence: 99%

European consensus on patient contact shielding

et al. 2021

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“…The interpreting radiologist should also remain alert of the possibility of obstruction and fistula. Evidence of testicular or penile prosthetic infection or migration should also be evaluated [3,14,20].…”

Section: Imaging Considerationsmentioning

confidence: 99%

“…A neovaginal exam can help determine prostate nodularity and suspicious nodules should be initially evaluated with transvaginal or transrectal ultrasound, being careful to understand the postoperative anatomy. As in natal males, prostate MRI can be pursued for further workup of malignancy [3].…”

Section: Imaging Considerationsmentioning

confidence: 99%

“…It is estimated that in the USA, nearly 1.6 million Americans, or 1 in 250 people, self-identify as transgender. While many of these people choose to align with their desired gender through altering their clothing and cosmetic appearance, a smaller fraction may opt to pursue GAS [2,3]. Among this group, transgender women are significantly more likely to pursue surgical options over transgender men [4••].…”

Section: Introductionmentioning

confidence: 99%

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Imaging in Gender Affirmation Surgery

2021

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Purpose of Review This review summarizes recent developments in gender affirmation surgery, imaging findings in patients undergoing these surgeries, focusing on common postoperative radiologic appearances, complications, and pitfalls in interpretation. Recent Findings The imaging workup of masculinizing and feminizing genitourinary surgeries uses multiple modalities in presurgical planning and within the immediate and long-term postoperative period. CT and MRI can help identify immediate and remote postoperative complications. Fluoroscopic examinations can diagnose postoperative urethral complications after gender affirmation surgeries. Lastly, the patients can undergo imaging for unrelated acute and chronic pathology, and knowledge of these imaging findings can be very helpful. Summary Imaging plays a significant role in the care of transgender patients and, particularly, in those pursuing gender affirmation surgery. As insurance coverage expands for these surgical procedures, radiologists should be prepared to encounter, understand, and interpret pre and postoperative findings.

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“…The optimal patient care experience will include respectful use of the patient's preferred pronouns, ample time and space allocated for the imaging examination (9), and use of layered pads and towels to prevent urine contamination artifacts from degrading image quality. At every step, we strive to provide clear instructions to the patient and enlist their help in positioning to limit radiation exposure and promote physicianpatient collaboration.…”

Section: Transmasculine Urethrography Special Considerations and Techniquementioning

confidence: 99%

Urethrographic Evaluation of Anatomic Findings and Complications after Perineal Masculinization and Phalloplasty in Transgender Patients

Dabela-Biketi

Mawad

et al. 2020

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Transgender patients seeking gender-affirming surgery are a growing population with unique health care needs. The radiologist must understand the challenges these patients face to facilitate a positive patient-physician interaction during the series of postoperative fluoroscopic evaluations. The authors present a standard two-stage surgical approach and common postoperative fluoroscopic findings after perineal masculinization and phalloplasty procedures. Perineal masculinization including urethral lengthening is performed first, followed by skin-flap-based phalloplasty. Patients undergo voiding cystourethrography (VCUG) after intravesical administration of contrast media by way of an indwelling suprapubic catheter after each stage. Retrograde urethrography plays a complementary role to supplement the limitations of VCUG after the second stage. The article reviews the expected postoperative anatomy and explains standardized terminology developed at the authors' institution. Imaging features of common and rare complications are discussed, including contained leak, stenosis, occlusion, and fistula. The successful postoperative imaging study in a transmasculine patient relies on open communication among the interdisciplinary team of specialized surgeons, radiologists, and medical providers, as well as special modifications to existing imaging techniques. © RSNA, 2020 • radiographics.rsna.org

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Transgender Patients: What Radiologists Need to Know

Cited by 31 publications

References 28 publications

European consensus on patient contact shielding

European consensus on patient contact shielding

Imaging in Gender Affirmation Surgery

Urethrographic Evaluation of Anatomic Findings and Complications after Perineal Masculinization and Phalloplasty in Transgender Patients

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