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Rationale and Objectives An increase in the administrative work in our healthcare system has led to an increase in the number of administrative positions in radiology departments. Many of these are Vice Chair roles, including Vice Chair for Education (VCEd). The responsibility of this position has expanded, often far beyond the original definition. This article defines the role and expectations of the Vice Chair for Education and provides suggestions for success. Materials and Methods This article will review 12 vital roles that a Vice Chair for Education must play to be an effective advocate for radiology education within a department. Results Key attributes of an educational leader are delineated, divided into 12 areas or roles. Conclusion This article summarizes key leadership skills needed by Vice Chairs for Education in order for them to be effective in their role.

Rationale and Objectives: There are little data as to whether appropriate, cost effective, and safe ordering of imaging examinations are adequately taught in US medical school curricula. We sought to determine the proportion of noninterpretive content (such as appropriate ordering) versus interpretive content (such as reading a chest x-ray) in the top-selling medical student radiology textbooks. Materials and Methods: Weperformedanonlinesearchto identifya rankedlistofthesix top-selling generalradiology textbooksfor medical students. Each textbook was reviewed including content in the text, tables, images, figures, appendices, practice questions, question explanations, and glossaries. Individual pages of text and individual images were semiquantitatively scored on a six-level scale as to the percentage of material that was interpretive versus noninterpretive. The predominant imaging modality addressed in each was also recorded. Descriptive statistical analysis was performed. Results: All six books had more interpretive content. On average, 1.4 pages of text focused on interpretation for every one page focused on noninterpretive content. Seventeen images/figures were dedicated to interpretive skills for every one focused on noninterpretive skills. In all books, the largest proportion of text and image content was dedicated to plain films (51.2%), with computed tomography (CT) a distant second (16%). The content on radiographs (3.1:1) and CT (1.6:1) was more interpretive than not. Conclusions: The current six top-selling medical student radiology textbooks contain a preponderance of material teaching image interpretation compared to material teaching noninterpretive skills, such as appropriate imaging examination selection, rational utilization, and patient safety.

Rationale and Objectives Ultrasound is used increasingly in medical practice as a tool for focused bedside diagnosis and technical assistance during procedures. Widespread availability of small portable units has put this technology into the hands of many physicians and medical students who lack dedicated training, leaving the education and introduction of this key modality increasingly to physicians from other specialties. We developed a radiology-led program to teach ultrasound skills to preclinical medical students. Materials and Methods To develop this new ultrasound program we 1) established a program leader, 2) developed teaching materials, 3) created a hands-on interactive program, and 4) recruited the necessary instructors. The program was piloted with the first-year medical student class of 154 students. The introductory session was assessed by pre- and post-activity Likert scale–based surveys. Results Of 154 (68.8%) students, 106 completed a voluntary online survey before starting the program and 145 students (94.2%) completed a voluntary survey after the session. Students found the program educationally valuable (4.64 of 5) and reported that it improved their understanding of ultrasound imaging (4.7 of 5). Students' reported confidence in identifying abdominal organs, intra-abdominal fluid, and Morison pouch that was significantly higher on the postactivity survey compared to the presurvey ( P Conclusions We piloted a radiology-led program to teach ultrasound skills to preclinical medical students. Students found the experience enjoyable and educationally valuable.

Rationale and Objectives Most fluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography with computed tomography (PET/CT) studies are performed on cancer patients. These patients are at increased risk of pulmonary embolism (PE). In this retrospective review, we determined the rate of PE, and the prevalence of associated FDG-PET findings on intravenous (IV) contrast-enhanced PET/CT. Materials and Methods We identified all PET/CT studies performed at our institution with a reported finding of PE between January 2005 and October 2012. The medical record was reviewed for symptoms, which were identified after the diagnosis of PE, and whether the patients received treatment. The prevalence of associated FDG-PET findings was determined. Results A total of 65 total cases of PE (of 182,72 total PET/CT examinations) were identified of which 59 were previously unknown. This gives an incidental PE (IPE) rate of 0.32%. Of the patients where sufficient clinical information was available, 34 of 36 (94%) were treated either with therapeutic anticoagulation or inferior vena cava filter, and 30 of 36 (83%) were asymptomatic in retrospect. Of the patients with IPE, we found nine (15.2%) with associated focal pulmonary artery hypermetabolism, three (5.1%) with hypermetabolic pulmonary infarction, and one with increased isolated right ventricular FDG uptake (1.7%). One case of chronic PE demonstrated a focal hypometabolic filling defect in a pulmonary artery on PET. Conclusions We found IPE in 0.32% of PET/CT scans. Focal pulmonary artery hypermetabolism or hypometabolism, and hypermetabolic pulmonary artery infarction with the “rim sign” were uncommonly associated with PE. These findings could raise the possibility of IPE in non-IV contrast-enhanced PET/CT studies.

Learning objectives are a critical step in the creation and implementation of a radiology curriculum. Their use is mandated by the Liaison Committee on Medical Education, the Accreditation Council on Graduate Medical Education, and the Accreditation Council on Continuing Medical Education, but more importantly they can have a significant beneficial impact on quality of radiology education programs. Learning objectives guide student learning, help clarify our teaching goals, and simplify learner testing and evaluation. This article will review the components of a proper learning objective and provide a simple, straightforward approach to writing them effectively.

Rationale and Objectives The aim of this report is to describe preliminary experience with an educational tool implemented to improve radiology education and documentation, in anticipation of upcoming changes from the American Board of Radiology and the Accreditation Council for Graduate Medical Education. Materials and Methods Monthly online end-of-rotation examinations were developed for junior radiology residents. Examinations were administered over a period of 6 months, after which satisfaction surveys were administered to residents and faculty members. Results Satisfaction with end-of-rotation examinations was high for residents and faculty members, but the level of resident satisfaction was not statistically different when compared to that of residents who had taken fewer examinations. Conclusions End-of-rotation examinations are relatively straightforward to implement and facilitate recurring, structured, and meaningful resident evaluation and feedback. Future studies will explore whether examinations such as these result in improved clinical competency.

Initial risk stratification for patients with pulmonary embolism (PE) is based on clinical assessment and rapidly separates those who are hemodynamically stable from those who are unstable. Unstable patients have a high short-term mortality and are candidates for thrombolysis. A subset of stable pat

Two patients with renal cell carcinoma and one patient with metastasis to the kidney from colorectal cancer are reported because all three cases manifested at computed tomography (CT) as a renal mass invading the pelvicaliceal system and radiologically simulating transitional cell carcinoma. Recognition that the CT finding of a renal mass with invasion of the pelvicaliceal system is not always indicative of a transitional cell carcinoma broadens the differential diagnosis in this setting and might potentially alter the diagnostic and therapeutic approach.

Author(s): Kathiria, Nazima N; Devcic, Zlatko; Chen, James S; Naeger, David M; Hope, Michael D; Higgins, Charles B; Ordovas, Karen G | Abstract: PurposeBecause left ventricular (LV) enlargement (LVE) is indicative of an array of cardiac pathologies, including cardiomyopathic, ischemic, and valvular heart diseases, it is important to recognize it early in the course of these diseases. The recognition of LVE on nongated contrast-enhanced computed tomography (CT) scans should be facilitated by the availability of a dimensional index. To our knowledge, no CT index of LVE has been proposed. Therefore, the study aimed to define whether the maximum LV diameter (LVd) measured on nongated multidetector computed tomography can identify LVE when referencing echocardiography as the diagnostic standard.Materials and methodsThe patient population consisted of 438 consecutive patients who had a contrast-enhanced, nongated 16- or 64-detector CT of the chest for evaluation of pulmonary embolism or aortic dissection between January 2006 and March 2008. One hundred fifty-five patients in this group also had an echocardiogram within 2 months of the CT study. The maximum LV cavity size, septal to lateral wall dimension, was measured perpendicularly to the long axis of the left ventricle on the axial CT scans by 2 observers blinded to the echocardiography data.An receiver operating characteristic analysis was performed to identify a highly specific cutoff for the diagnosis of LVE on CT, using echocardiogram as the standard of reference. Interobserver agreement was assessed using Bland-Altman analysis.ResultsA total of 84 females and 71 males were evaluated (female to male ratio of 1.09). The mean age for the 155 patients was 58 years. Six percent of these patients had a diagnosis of LVE on 2-dimensional echocardiography. The mean (SEM) LV internal diameter at nongated multidetector computed tomography between the group with normal LV and the group with LVE by echocardiography was 4.4 (0.7) cm for the normal LV and 5.9 (1.2) cm for the dilated LVs (P l 0.0001). With the use of threshold value of LVd of 5.6 cm, a sensitivity of 78%, specificity of 100%, positive likelihood ratio of 113.5, and negative likelihood ratio of 0.22 were calculated. The LVd measurements had an excellent agreement between observers on the Bland-Altman analysis.ConclusionsLeft ventricular enlargement can be reliably identified on nongated contrast-enhanced multidetector CT when the maximum luminal diameter of the LV is greater than 5.6 cm. Nongated contrast-enhanced CT scan can be used to recognize LVE.

Teaching is an important skill. Academic physicians teach on a daily basis, and nearly all physicians occasionally teach colleagues and patients. There are generally few opportunities for medical students to learn teaching skills. We developed a novel "near-peer" teaching program in which fourth-year students cotaught first-year students.Eighteen fourth-year students enrolled in our institution's primary senior radiology elective learned the basics of ultrasound through a series of lectures and hands-on scanning sessions. Each fourth-year student, paired with a radiology resident or attending, then cotaught a first-year anatomy small group session. After instruction, voluntary surveys were administered to assess the perceived value of the "near-peer" teaching experience.Seventeen of 18 (94%) and 104 of 120 (87%) administered surveys were returned by fourth- and first-year students, respectively. Sixteen (94%) and 99 (95%) of the fourth- and first-year students reported they "enjoyed" or "really enjoyed" the near-peer teaching experience. Fourteen (82%) of the fourth years perceived improvement in their teaching skills and an increase in their knowledge. Only 8 (47%) of the fourth years thought they were "helpful" or "very helpful," though 92 (88%) of the first years identified their fourth-year co-instructors as "helpful" or "very helpful."We piloted a novel "near-peer" program. Both senior and freshman students enjoyed the experience, and fourth years thought the session was educational for them as well. Although most fourth years did not judge themselves as helpful, first-year students overwhelmingly considered them a useful addition to the session.