Blockchain Technology: Principles and Applications in Medical Imaging.

Blockchain is an immutable, encrypted, distributed ledger technology. While initially devised for and most commonly referenced with cryptocurrencies, there are an increasing number of applications outside finance, many of which are relevant to medical imaging. In this paper, the concepts and principles underlying the technology and applications relevant to medical imaging are discussed, in addition to potential challenges with implementations such as public versus private key access, distributed ledger size constraints, speed, complexity, and security pitfalls. Potential use cases for blockchain specifically relevant to medical imaging include image sharing including direct patient ownership of images, tracking of implanted medical devices, research, teleradiology, and artificial intelligence. While blockchain offers exciting ways to facilitate the storage and distribution of medical images, similar to the advent of picture archiving and communication systems decades ago, it does have several key limitations of which healthcare providers of medical imaging and imaging informatics professionals should be aware.

Efficacy and safety of partial splenic embolization for hypersplenism in pre- and post-liver transplant patients: A 16-year comparative analysis.

PURPOSE: To report the effect of partial splenic embolization (PSE) on hematological indices and the procedure's safety in pre- and post-liver transplant (LT) patients. MATERIALS AND METHODS: A single-center retrospective study evaluating all patients who underwent PSE over a 16-year period was performed. Inclusion criteria were splenomegaly confirmed by imaging and at least one of the following cytopenias: hemoglobin ≤10 g/dL, WBC count ≤1500 µL-1, or platelet count ≤100,000 µL-1. 38 of 102 patients (37%) met criteria (24 pre- and 14 post-LT) for a total of 40 PSEs. RESULTS: No effect was seen on median hemoglobin beyond 2 weeks post-PSE. There was a significant and sustained increase in median WBC counts (from 3400 µL-1 to 5400 µL-1 at 2 years) and platelet count (from 65,000 µL-1 to 117,000 µL-1 at 3.5 years). In 6 out of 40 PSEs (15%) a major complication occurred which included pleural effusion, ascites, spontaneous bacterial peritonitis, pneumonia, and inferior vena cava thrombus. Similar efficacy was observed in pre- and post-LT cohorts, with a trend toward higher complication rate in pre-LT patients. CONCLUSIONS: PSE is efficacious in increasing WBC count out to 2 years and platelet count out to 3.5 years in patients with hypersplenism. Efficacy and safety appeared independent of pre- or post-LT status. The intervention is associated with major complications and special care should be taken when selecting patients for PSE.

Residents teaching medical students: how do they compare with attending educators?

PURPOSE: Educating medical students is a core mission of academic radiology departments. In some programs, residents participate in student teaching. The aim of this study was to retrospectively compare medical student evaluations of radiology resident lectures with lecture evaluations of radiology faculty members. METHODS: Numeric evaluations for lectures given by faculty members, fellows, and residents were collected over a 1-year period as part of routine course evaluations for a fourth-year medical student radiology elective. Faculty member, fellow, and resident lecture scores were compared, overall using analysis of variance and pairwise using Student's t test. A predefined low P-value threshold was used for the t tests to account for the multiple comparisons. To account for the inherent clustering of the data due to repeat lecturers, the data were reanalyzed on a "per lecturer" basis. RESULTS: Three hundred seven individual lecture scores were collected. There was no statistical difference between the lecture scores received by attending faculty members (mean, 9.10 on a scale of 10) and residents (mean, 8.99) (P = .08). Fellows, however, scored statistically significantly lower (mean, 8.45) than attending faculty members and residents (P <.001 for both comparisons). The per lecturer analysis yielded similar results. CONCLUSIONS: Lectures delivered by residents received similar evaluations as lectures delivered by faculty members. Given that teaching can be an educational experience for residents, involving radiology residents in medical student teaching may benefit students and residents alike.