Senior Resident Grand Rounds: Results From a Survey of 15 Years of Radiology Residency Graduates.

OBJECTIVE: Radiology residents in their final year of training at our institution are required to deliver a grand rounds presentation prior to graduation in order to facilitate resident involvement in the medical tradition of ground rounds. We evaluated this requirement by conducting a survey of recent residency alumni on their experience delivering grand rounds and its perceived value in radiology training. MATERIALS AND METHODS: We developed an anonymous, 10-question survey regarding the alumni experience with the grand rounds presentation requirement, which has been required since 2007. Question formats included yes-or-no and 5 point Likert-type formats, as well as a space to provide comments. RESULTS: Eighty-three alumni were contacted and 39 responded (46.9% response rate). Current practice setting was academic in 41.0%, 46.2% have reused material from their presentation, and 46.2% have given a grand rounds presentation since completing residency. When asked if delivering the presentation was a valuable experience, 2.6% disagreed, 23.1% were neutral, 35.9% agreed, and 38.5% strongly agreed. When asked if they would recommend future senior residents to give a grand rounds presentation, 2.6% strongly disagreed, 30.8% were neutral, 30.8% agreed, and 35.9% strongly agreed. CONCLUSIONS: The majority of survey respondents agree or strongly agree their grand rounds presentation experience was valuable and would recommend future residents to continue this process. Based on survey comments, we conclude this experience is valuable for multiple reasons, including the opportunity to demonstrate mastery of a radiology topic, the ability to repurpose presentation material in the future, and the experience of delivering a formal presentation.

Prevalence of extra-hepatic incidental findings on ultrasound screening for hepatocellular carcinoma.

PURPOSE: Abdominal ultrasound is a cost-effective method for screening for hepatocellular carcinoma (HCC) in high-risk individuals. Currently, at many institutions the protocol for obtaining HCC screening ultrasounds includes a traditional examination of the right upper quadrant, including the pancreas and right kidney. There is no consensus on the role of imaging of extra-hepatic structures and there are limited data describing the frequency and clinical significance of incidental findings discovered during HCC screening. The purpose of this retrospective study is to assess the prevalence and significance of extra-hepatic incidental findings during HCC screening ultrasounds. METHODS: A single-center retrospective review of all right upper quadrant HCC screening ultrasounds identified 432 HCC screening ultrasounds performed on 294 adults over a 2.5-year period. Findings in all organs evaluated were recorded. Any incidental finding was classified as minor, moderate, or major clinical significance. RESULTS: At least one extra-hepatic finding was documented in 57.4% of examinations. The most common extra-hepatic findings occurred in the gallbladder (40.3%), most commonly gallstones (25.4%). Four moderate clinically significant incidental findings were recorded (0.9%). Only one of these incidental findings required specific imaging follow up (0.2%). No major clinical significance incidental findings were identified. CONCLUSIONS: Potentially clinically significant incidental findings during ultrasound HCC screenings are rare. Incidental findings identified on HCC screening did not result in significant additional follow-up imaging or interventions.

Sonographic Evaluation of Genitourinary Inflammatory Pseudotumors and Its Mimics.

ABSTRACT: Inflammatory pseudotumor is a relatively rare, nonneoplastic lesion composed of inflammatory cells and myofibroblastic spindle cells that can be identified on sonographic evaluation of the genitourinary system. These lesions are thought to be an inflammatory response to insults such as surgery, trauma, infection, or malignancy. Such lesions need to be distinguished from true neoplasms and other benign lesions, including inflammatory responses and infectious processes. Identification of inflammatory pseudotumors and its mimics is important for radiologists to guide patient treatment and follow-up. This pictorial essay presents sonographic features of inflammatory pseudotumors of the genitourinary tract and its mimics with cross-sectional imaging and histopathology, where available.

Effect of a Decision Aid on Decision Making for the Treatment of Pelvic Organ Prolapse.

OBJECTIVES: The aim of this study was to evaluate if the addition of a decision aid (DA) decreases decisional conflict in women presenting for the management and treatment of pelvic organ prolapse (POP). METHODS: Women scheduled for the evaluation and management of POP were randomized into either of 2 groups: standard counseling (SC) alone (n = 51) or SC plus a DA (n = 53). Upon completion of their initial visit, patients filled out a 16-item decisional conflict scale and short form general health survey. Values were assessed for normality and compared between groups. Normally distributed, continuous data were evaluated with a Student t test. A χ2 test was used to compare selected categorical characteristics between groups. Differences in distributions of low and high decisional conflict were assessed with a Mann-Whitney U test. RESULTS: One hundred four women were randomized for this analysis. Baseline characteristics, including pelvic prolapse examination measurements, did not significantly differ between groups. The addition of a DA to SC did not significantly lower the level decisional conflict patients faced when deciding on a treatment plan (P = 0.566). There were no significant differences between groups in the following subscores: uncertainty, values clarity, support, effective decision, and informed. In addition, there were no between-group differences in choice of treatment plan (conservative management, pelvic floor physical therapy, pessary, and surgery; P = 0.835). CONCLUSIONS: In this relatively small sample, the addition of a DA to SC for women with POP does not significantly decrease the level of decisional conflict in making treatment-related decisions.