Noncalcified Lung Nodules: Volumetric CT Assessment
Size measurement of lung nodules must be accurate and consistent to enable assessment of nodule change in a short time.
 Axial CT section shows phantom with synthetic nodule attached to the vasculature in left lung. (Reprinted, with permission, from Kinnard LM, Gavrielides MA, Myers KJ, et al., "Volume error analysis for lung nodules attached to bronchial vessels in an anthropomorphic thoracic phantom." In: Giger ML, Karssemeijer N, eds. Proceedings of SPIE: Medical Iimaging 2008-Computer-aided Diagnosis. Vol 6915. Bellingham, Wash: International Society for Optical Engineering, 2008.) |
In a review article in the April issue of Radiology (RSNA.org/radiology), Marios A. Gavrielides, Ph.D., of the National Institute of Biomedical Imaging and Bioengineering and U.S. Food and Drug Administration in Silver Spring, Md., and colleagues review findings from published studies relevant to the volumetric CT analysis of lung nodules, focusing on the extent of error in the volume-based estimation of nodule size.
In addition to identifying a number of under-examined areas of research regarding volumetric assessment of lung nodules, including the effects of pitch and section collimation, researchers specifically examine:
• Effect of different factors on the volumetric assessment of lung nodules with thoracic CT, including image acquisition, reconstruction parameters and nodule characteristics
• Performance of algorithms for nodule segmentation and volume estimation
While pointing to the need for continued research, Gavrielides and colleagues promote understanding and try to quantify the sources of volumetric measurement error in assessing lung nodules with CT as a first step toward developing methods to minimize that error. "An understanding of the sources and extent of error would allow software developers and users of quantitative imaging to control for these effects through system improvements (hardware, software and operator contributions), while physicians could incorporate this knowledge into their assessment of lung nodule change and patient care," the researchers conclude.
(Radiology 2009;251:26-37)
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Strategies for Establishing a Comprehensive Quality and Performance Improvement Program in a Radiology Department
To ensure safety, accuracy and high-quality care and maintain a competitive edge, imaging departments should establish and manage comprehensive and effective performance improvement programs, many of which are mandated by regulatory agencies.
 Graph and chart illustrate the monitoring of compliance with the Joint Commission's National Patient Safety Goals and several radiology-specific metrics. When note is made that an adverse event (for example, bleeding requiring hospital admission) occurred following an imaging-guided procedure (for example, ultrasonography-guided liver biopsy), the review process is used to link this information to an adverse event reporting system to ensure that the event has been or is now being recorded. The data are then further linked to the departmental procedural complication key performance indicator. IR = interventional radiology. (RadioGraphics 2009;29:315–329) |
In an article in the March-April issue of RadioGraphics (RSNA.org/radiographics), Jonathan B. Kruskal, M.D., Ph.D., of Harvard Medical School and chair of radiology at Beth Israel Deaconess Medical Center in Boston, and colleagues define various terms commonly used in quality management, review principles of performance improvement and describe essential "ingredients" of an effective program. Specifically, the authors discuss:
• Principles of quality and performance improvement and key elements in ensuring the success of an improvement program
• Specifics of applying quality management to radiology, including compliance with regulatory groups
• Key performance indicators and their applications in a radiology department
Although their structure and focus can vary, programs share a number of common components including patient safety, process improvement, customer and consumer relations, professional staff assessment and education. "For each component, we describe strategies for implementing continuous programs to monitor performance, analyzing and depicting data, implementing change and meeting regulatory requirements," the authors write.
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