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Abstract: The purpose of this study was to determine the frequency and outcomes of breast malpractice suits among all enrollees in One Call Medical Inc.'s panel of interpreting radiologists nationally and to evaluate state‐by‐state variations. The 8401 radiologists enrolled had 4764 suits, of which 826 were related to breast disease. In New York and New Jersey, the ratio of breast suits to One Call Radiologists was 0.28 and 0.27, twice as much as in any other state. Breast suits in radiology have a wide variation in frequency across the country with New York and New Jersey far exceeding all others in relative frequency and number of radiologists with multiple breast suits. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented discussing a study demonstrating that there are different conceptions regarding pain and its associated risks, citing culture as appearing to have played a role in how people perceive pain differently.

Abstract: The authors present an illustrative case of occult transorbital penetrating intracranial injury in a child, and review the literature concerning patterns of low-velocity, non-projectile injury during the era of modern CT and MRI study. Review of the mechanism of injury and analysis of surface entry site of penetration in 38 cases suggests recurring patterns of injury in occult and non-occult cases. A classification system based on surface entry zone site is applied to these injuries. Knowledge of the classification system should increase clinical suspicion for this type of often occult, penetrating orbito-cranial injury and direct appropriate investigation to provide earlier detection and diagnosis of the transorbital, intracranial penetration. [Copyright &y& Elsevier]

In this study, we performed dual-modality optical coherence tomography (OCT) characterization (volumetric OCT imaging and quantitative optical coherence elastography) on human breast tissue specimens. We trained and validated a U-Net for automatic image segmentation. Our results demonstrated that U-Net segmentation can be used to assist clinical diagnosis for breast cancer, and is a powerful enabling tool to advance our understanding of the characteristics for breast tissue. Based on the results obtained from U-Net segmentation of 3D OCT images, we demonstrated significant morphological heterogeneity in small breast specimens acquired through diagnostic biopsy. We also found that breast specimens affected by different pathologies had different structural characteristics. By correlating U-Net analysis of structural OCT images with mechanical measurement provided by quantitative optical coherence elastography, we showed that the change of mechanical properties in breast tissue is not directly due to the change in the amount of dense or porous tissue., Competing Interests: The authors declare no conflicts of interest., (© 2021 Optical Society of America under the terms of the OSA Open Access Publishing Agreement.)

We investigated a deep learning strategy to analyze optical coherence tomography image for accurate tissue characterization based on a single fiber OCT probe. We obtained OCT data from human breast tissue specimens. Using OCT data obtained from adipose breast tissue (normal tissue) and diseased tissue as confirmed in histology, we trained and validated a convolutional neural network (CNN) for accurate breast tissue classification. We demonstrated tumor margin identification based CNN classification of tissue at different spatial locations. We further demonstrated CNN tissue classification in OCT imaging based on a manually scanned single fiber probe. Our results demonstrated that OCT imaging capability integrated into a low-cost, disposable single fiber probe, along with sophisticated deep learning algorithms for tissue classification, allows minimally invasive tissue characterization, and can be used for cancer diagnosis or surgical margin assessment.

We develop a spatial coordinate corrected (SCC) motion tracking method for optical coherence elastography. SCC motion tracking refers the instantaneous velocity field extracted from optical coherence tomography (OCT) data to the laboratory coordinate system and accurately reconstructs the displacement field established during the mechanical excitation (compression) process. We acquired image data from compression OCE experiments on human breast tissue specimens, and reconstructed the displacement field through Doppler analysis of OCT data. Our results suggested that SCC tracking enables accurate reconstruction of displacement field, and enables effective identification mechanical heterogeneity that can be used as a biomarker for cancer diagnosis and tumor margin assessment.

We investigate a spatial coordinate correction (SCC) method to track motion with high accuracy for optical coherence elastography (OCE). Through SCC, we refer the displacement field tracked by optical coherence tomography (OCT) in the loaded sample to individual material points defined in a fixed coordinate system. SCC allows OCE to perform spatially and temporally unambiguous tracking of displacement and enables accurate mechanical characterization of biological tissue for cancer diagnosis and tumor margin assessment. In this study, we validated the effectiveness of motion tracking based on SCC using experimental OCE data obtained from ex vivo human breast tissues., Competing Interests: The authors declare that there are no conflicts of interest related to this article., (© 2019 Optical Society of America under the terms of the OSA Open Access Publishing Agreement.)

Introduction: Medical students are a significant source of the future academic medicine workforce, but surprisingly little is typically done to promote academic medicine career awareness during the early stages of medical education. To raise awareness among medical students of the critical role an academic residency plays in pursuing a future academic career, we developed a workshop that describes what an academic residency entails and what to consider when selecting such a program., Methods: The six-step Kern model was applied to develop a multimodal workshop to help trainees understand characteristics of and explore their interest in an academic residency program. The 60-minute workshop consists of a PowerPoint presentation, reflection exercise, and case scenarios to help trainees learn and apply new skills in selecting a residency program. The workshop was offered to diverse medical students at nine different medical schools across the country between July 2016 and May 2017., Results: Of the 115 workshop participants who completed the evaluation form, over 95% agreed or strongly agreed that each of the learning objectives was met. A paired t test of learner responses pre- and postworkshop demonstrated significantly increased confidence in finding an academic residency position., Discussion: This workshop fills an important gap in raising medical students' awareness of how to pursue an academic medicine career by highlighting the critical role of an academic residency program. Participants liked the use of vignettes and small-group discussion to better prepare them in exploring and benefiting from an academic residency position.

We developed a miniature quantitative optical coherence elastography (qOCE) instrument with an integrated Fabry-Perot force sensor, for in situ elasticity measurement of biological tissue. The technique has great potential for biomechanics modeling and clinical diagnosis. We designed the fiber-optic qOCE probe that was used to exert a compressive force to deform tissue at the tip of the probe. Using the space-division multiplexed optical coherence tomography (OCT) signal detected by a spectral domain OCT engine, we were able to quantify the probe deformation that was proportional to the force applied, and to quantify the tissue deformation corresponding to the external stimulus. Simultaneous measurement of force and displacement allowed us to extract Young's modulus of biological tissue. We experimentally calibrated our qOCE instrument, and validated its effectiveness on tissue mimicking phantoms and biological tissues.

Speckle decorrelation analysis of optical coherence tomography (OCT) signal has been used in motion tracking. In our previous study, we demonstrated that cross-correlation coefficient (XCC) between Ascans had an explicit functional dependency on the magnitude of lateral displacement (δx). In this study, we evaluated the sensitivity of speckle motion tracking using the derivative of function XCC(δx) on variable δx. We demonstrated the magnitude of the derivative can be maximized. In other words, the sensitivity of OCT speckle tracking can be optimized by using signals with appropriate amount of decorrelation for XCC calculation. Based on this finding, we developed an adaptive speckle decorrelation analysis strategy to achieve motion tracking with optimized sensitivity. Briefly, we used subsequently acquired Ascans and Ascans obtained with larger time intervals to obtain multiple values of XCC and chose the XCC value that maximized motion tracking sensitivity for displacement calculation. Instantaneous motion speed can be calculated by dividing the obtained displacement with time interval between Ascans involved in XCC calculation. We implemented the above-described algorithm in real-time using graphic processing unit (GPU) and demonstrated its effectiveness in reconstructing distortion-free OCT images using data obtained from a manually scanned OCT probe. The adaptive speckle tracking method was validated in manually scanned OCT imaging, on phantom as well as in vivo skin tissue.

Objective: Our aim was to evaluate the histologic characteristics of tissue extracted on the probe immediately after radiofrequency ablation of malignant tumors in the liver., Materials and Methods: From April to December 2001, 20 radiofrequency ablations were performed in 19 patients with primary (n = 17) and metastatic (n = 2) liver masses. Track ablation according to device protocol was performed after each ablation. Tissue was adherent to the probe after all radiofrequency probe passes. All pieces of tissue found on the probe were collected and preserved in formalin., Results: Tissue was examined by the study pathologist. In eight (40%) of 20 specimens, coagulation necrosis was present. In five (25%) of 20 specimens, possibly nonviable tissue was extracted, although some cell characteristics were identified. In seven (35%) of 20 specimens with hepatocellular carcinoma, possibly viable tissue was found. Five specimens were identified as hepatocellular carcinoma, and two, as cirrhotic nodules., Conclusion: Histopathologic evaluation of the tissue extracted on the radiofrequency probe after ablation is feasible. This study showed that coagulation necrosis was clearly present in at least 40% of the patients, which proves that nonviable tissue can be seen immediately after ablation. Whether this pathologic finding has prognostic value is not known.