A roadmap of resident-led initiatives to promote research within the radiology department.

RATIONAL: While radiology residents must participate in a scholarly project per Accreditation Council for Graduate Medical Education (ACGME) Program Requirements, some residency programs may lack a well-thought out, cohesive approach to research that incorporates the residents' perspective. Our objective was to improve the radiology resident research experience with resident-led initiatives. MATERIAL AND METHODS: An annual resident research survey was created and distributed to 28 radiology residents in December 2018. Following the survey, a newly formed resident research committee developed a six-step strategic framework of resident-led initiatives to promote research and scholarly activity within the department: Reflect, Recruit, Regroup, Revive, Recognize, and Review. Outcomes of this framework were evaluated with the second annual resident research survey in December 2019. RESULTS: Our institution identified areas of improvement on the 2019 survey after the implementation of the six-step initiatives upon comparison to the 2018 survey. A greater number of residents reported that they had adequate or somewhat adequate resources for research within the department in 2019 (95.2% [20/21]) in comparison to 2018 (70.6% [12/17]) (p = 0.03). A greater percentage of residents found available research projects engaging/interesting in 2019 (80.9% [17/21]) compared to 2018 (70.6% 12/17) (p = 0.49). The most commonly reported departmental resources needed to encourage research on the 2019 survey were dedicated research time (26.9%, 18 out of 67 total responses) and mentorship/encouragement from the faculty (19.4%, 13/67). CONCLUSION: With a specific framework and appropriate departmental support, resident-led initiatives can improve the research experience within the radiology department from the residents' perspective.

Acute pancreatic graft fistula and peripancreatic fluid collection: demonstration by secretin-stimulated MRI.

Peripancreatic fluid collections are among the common post pancreas transplant complications, which are mainly due to leakage from the anastomosis site to bowel and graft pancreatitis. Differentiation between these two entities is important because they are treated differently. In this case, secretin stimulated magnetic resonance cholangiopancreatography revealed gradual intraperitoneal fluid collection and accumulation of fluid in small bowel excluded leakage from the anastomosis of the pancreas to bowel and changed the management from surgery to medical treatment.

Increased 18F-FDG uptake in the posterior ocular bulb is associated with brain metastasis: a retrospective study.

OBJECTIVE: An observation of increased (18)F-FDG uptake in the posterior ocular bulb led us to the hypothesis that increased posterior ocular bulb uptake is likely abnormal and may indicate intracranial lesions. MATERIALS AND METHODS: Fifteen healthy volunteers and 35 patients with lung carcinoma-14 without brain metastasis and 21 with brain metastases-were retrospectively studied. The individuals underwent whole-body PET/CT including the brain with low-dose and unenhanced CT. Two nuclear medicine physicians visually analyzed the posterior ocular bulb uptake of both eyes. Standardized uptake values (SUVs) in the posterior ocular bulb were compared among the study groups. A radiologist reviewed brain MRI scans for abnormalities in the ocular bulbs and orbits. RESULTS: Visual interpretation showed normal FDG uptake at the posterior ocular bulb in 14 of the 15 healthy volunteers and 12 of the 14 (86%) patients without brain metastasis. Seventeen of the 21 (81%) patients with brain metastases showed increased uptake in the posterior ocular bulb. Visual interpretation showed no statistically significant difference between the healthy volunteers and patients without brain metastasis (p = 0.671). However, there was a significant difference between the patients with brain metastases and healthy volunteers as well as patients without brain metastasis (both, p < 0.001). High interrater agreement (kappa = 0.83) was noted. Brain MRI showed no abnormalities at the posterior ocular bulb in all study subjects. SUV results were inaccurate because of the intense tracer activity in the posterior orbit nearby. A good correlation between visually increased posterior ocular bulb uptake and the presence of brain metastasis was present (Cramer's V = 0.61). CONCLUSION: Visually increased FDG uptake along the posterior ocular bulb is an abnormal finding and may indicate intracranial structural abnormalities such as brain metastases.

Diffusion-weighted MRI of the pancreas: correlation with secretin endoscopic pancreatic function test (ePFT).

RATIONALE AND OBJECTIVES: To evaluate the correlation between apparent diffusion coefficient (ADC) values of the pancreas on diffusion-weighted imaging (DWI) and pancreatic exocrine function determined by HCO(3) concentration in the secretin endoscopic pancreatic function test (ePFT). MATERIALS AND METHODS: Mean ADC values derived from 10 different points of the pancreatic gland on DWI were reviewed in 14 patients with normal (peak HCO(3) > or = 80 mEq/L) and 14 patients with abnormal (peak HCO(3) < 80 mEq/L) ePFT results. Magnetic resonance cholangiopancreatography (MRCP) images of the same patients were evaluated for the diagnosis of chronic pancreatitis. Correlation between ADC values and HCO(3) concentration as well as Cambridge scores in MRCP was performed using Spearman's correlation test. RESULTS: Mean ADC value of the pancreas was 1.52 +/- 0.13 x 10(-3) mm(2)/s in patients with abnormal ePFT results and 1.78 +/- 0.07 x 10(-3) mm(2)/s in the normal group. There was a significant statistical difference between the ADC values of the pancreas in the two groups (P < .0001). There was also a statistically significant correlation between HCO(3) level and ADC value of the pancreas in the study patients (r = 0.771, P < .0001). Morphologic changes of the pancreas according to the Cambridge classification were also well correlated with the mean ADC values (r = -0.763, P < .0001). CONCLUSIONS: Strong correlation between ADC value and pancreatic exocrine function as well as Cambridge score for chronic pancreatitis exists. Further studies are needed to determine the cut off ADC value for chronic pancreatitis.

Comparison between malignant and benign abdominal lymph nodes on diffusion-weighted imaging.

RATIONALE AND OBJECTIVES: The purpose of this study is to review the apparent diffusion coefficient (ADC) values of benign and metastatic abdominal lymph nodes on diffusion-weighted imaging (DWI). MATERIALS AND METHODS: Twenty-eight patients with a total of 40 benign (20 patients) and 16 malignant (8 patients) lymph nodes who underwent DWI MRI of the abdomen (b = 0.600) were enrolled in the study. ADC values of the lymph nodes were measured and comparison was made between benign and malignant groups. RESULTS: Mean ADC value of lymph nodes was 2.38 +/- 0.29 and 1.84 +/- 0.37 x 10(-3) mm(2)/sec in the benign and malignant groups, respectively. There was a significant statistical difference between the ADC values of benign and malignant lymph nodes (P < .0005). CONCLUSION: A wide range of ADC values exist in patients with metastatic abdominal lymph nodes, with a tendency of higher ADC values in benign lymph nodes.