Radiologic diagnosis and management of hyperacute stroke.
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Biomedical subjects
Publications and source records attributed to Jannette Collins.
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Education can be the focus of a rewarding and successful career in academic radiology. Educational opportunities for academic radiologists include teaching medical students, residents, nursing students, physician assistant students, radiology technologist students, and other allied health profession students. Teaching can occur in large or small groups, or as a one-on-one encounter. Teaching is the very best way to learn a subject well; thus, educators are often considered experts in their fields. Educators can develop innovative teaching materials that are passed on to generations of students. Opportunities in educational administration and personal development are available both locally and nationally. Participation in radiology education research allows a radiologist to contribute to the body of knowledge in radiology education and advance the field of radiology education through science.
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Regular meetings of residency program teaching faculty are required by the ACGME and support the educational mission of the department. The education committee should be viewed by the department chair and other members of the faculty as being equally important as the departmental research, operations, and finance committees. An education committee that is dedicated to promoting excellence in education and supports the educational mission of the department will enhance the department's local, regional, and national reputation.
RATIONALE AND OBJECTIVES: This study assessed medical student satisfaction with radiology lectures integrated into the 3rd-year student internal medicine clerkship, compared with faculty lectures in an independent radiology course, and investigated the effects of integrated instruction on departmental compensation from the medical school. MATERIALS AND METHODS: Students' evaluations were compared, with two-way analysis of variance, for faculty who presented lectures in an integrated radiology course and faculty who presented lectures in an independent radiology course from July 1998 to June 2001. Radiology department compensation from the medical school for each course was computed per contact hour. RESULTS: For the integrated course (663 evaluations), the mean overall faculty rating was 1.44 (1 = excellent, 5 = poor), lower (more positive) than the mean overall rating of 1.53 for the independent course (518 evaluations) (P = .037). The interaction between type of instruction and topic was significant only for chest and musculoskeletal imaging, which were rated more positive and less positive in the integrated course, respectively (P < .001). For the integrated course the radiology department received $762 per lecture hour, and for the independent course it received $296 per contact hour (all types) and $1,183 per lecture hour. CONCLUSION: Student ratings of faculty lectures in an integrated course were excellent and comparable to those in an independent radiology course. The medical school differentiated the efforts of radiology faculty in the two courses through its budgeting process, awarding greater compensation per contact hour for participation in the integrated course. If only lecture hours are considered, compensation was greater for the independent course.
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Lung transplantation is a well-accepted treatment for numerous lung diseases when medical or surgical therapy is ineffective or unavailable and the patient has a limited life expectancy (usually less than 2 to 3 years). When appropriate, single-lung transplantation is the preferred procedure because of a critical shortage of available donor lungs. Preoperative imaging is useful for selecting which lung should be transplanted, size matching between donor lung and recipient thorax, and screening for malignancy. Cardiac-related deaths, infection, and primary graft failure are the leading causes of perioperative death. Obliterative bronchiolitis is the "Achilles heel" of lung transplantation and accounts for the largest number of late deaths. This article reviews the preoperative, perioperative, and postoperative considerations and the utility of radiologic imaging after lung transplantation.
PURPOSE: To determine the frequency, clinical characteristics, and radiologic findings of bronchogenic carcinoma in patients surviving more than 1 month after lung transplantation. MATERIALS AND METHODS: The study population was composed of 2,168 consecutive patients at seven lung transplantation centers who survived longer than 1 month after lung transplantation. Medical records, chest radiographs, and computed tomographic (CT) scans obtained at the time of diagnosis and prior images when available were reviewed for various items of information and imaging features. RESULTS: Twenty-four (1%) of the 2,168 patients, all with single-lung transplants, developed cancer in the native lung. Eighteen patients had emphysema, and six had pulmonary fibrosis. The frequencies of cancer in patients with emphysema and fibrosis were 2% (18 of 859 patients) and 4% (six of 147 patients), respectively. Twelve (50%) of their 24 cancers were detected at chest radiography. Fourteen (58%) patients had clinical symptoms. Twenty-one (88%) of the 24 patients had one (n = 11) or more (n = 10) nodules, and nine (38%) had one (n = 8) or more (n = 1) masses visible on CT scans. Nodules and masses were visible on 12 (50%) and seven (29%) of 24 chest radiographs, respectively. Eleven (48%) of 23 cancers for which prior chest radiographs were available were seen retrospectively on prior chest radiographs. CONCLUSION: Bronchogenic carcinoma develops in the native lung of transplant recipients with emphysema and pulmonary fibrosis with frequencies of 2% and 4%, respectively. The carcinomas most commonly manifest as a pulmonary nodule or mass on chest radiographs, with more nodules seen on CT scans.
As a result of recent publications in the lay press, individuals have started to ask physicians and other medical personnel about the availability of screening CT for lung cancer. Many imaging centers, perhaps without full knowledge of the complex issues involved, have capitalized on this enthusiasm by instituting CT screening programs. Whether a health care provider offers screening CT or not, physicians and other medical personnel need to be informed about recent developments in CT screening for lung cancer in order to advise patients. This article reviews the significance of lung cancer as a cause of death, the causes of lung cancer and how it can be prevented, the types and frequencies of different lung cancers, the conditions of effective screening, the biases associated with screening, and past and present lung cancer screening trials.
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The purpose of this article is to familiarize the chest radiologist with the basics of PET scanning in the chest and to correlate PET findings with thoracic CT findings. After completing this article, the reader should know the following: (a) how PET scanning is performed; (b) the indications for PET scanning in the chest; (c) the significance of SUV and a positive test; (c) the causes of false-positive and false-negative PET scans; and (d) the importance of correlating PET findings with Chest CT findings. The authors conclude that PET and chest CT studies should be read in conjunction to optimize diagnostic accuracy. Interpreting either study alone is fraught with errors, while combined interpretations yield information on both functional activity and anatomic localization. PET-CT hybrid devices that fuse PET and CT data simplify this task and fusion imaging is rapidly becoming the test of choice for evaluating thoracic malignancies.
Effectiveness of an oral presentation depends on the ability of the speaker to communicate with the audience. An important part of this communication is focusing on two to five key points and emphasizing those points during the presentation. Every aspect of the presentation should be purposeful and directed at facilitating learners' achievement of the objectives. This necessitates that the speaker has carefully developed the objectives and built the presentation around attainment of the objectives. The best presentations are rehearsed, not so that the speaker memorizes exactly what he or she will say, but to facilitate the speaker's ability to interact with the audience and portray a relaxed, professional, and confident demeanor. Rehearsal also helps alleviate stage fright. The most useful method of controlling nervousness is to visualize success. When showing images, it is important to orient the audience with an adequate description, point out the relevant findings, and allow enough time for the audience to assimilate the information before moving on. This can be facilitated with appropriate use of a laser pointer, cursor, or use of builds and transitioning. A presentation should be designed to include as much audience participation as possible, no matter the size of the audience. Techniques to encourage audience participation include questioning, brainstorming, small-group activities, role-playing, case-based examples, and directed listening. It is first necessary to motivate and gain attention of the learner for learning to take place. This can be accomplished through appropriate use of humor, anecdotes, and quotations. Attention should be given to posture, body movement, eye contact, and voice when speaking, as how one appears to the audience will have an impact on their reaction to what is presented.
Most radiologists are now creating their own image and text slides for oral presentations. PowerPoint software offers a tremendous number of options for personalizing slides. Having choices of font, color scheme, display options, sound, and graphics provide an opportunity to enhance a presentation in ways that were not possible with 35-mm slides and slide projectors. However, inappropriate use of PowerPoint features can substantially degrade the quality of a presentation. Many of the "rules" for creating an effective presentation given with slide projectors apply to electronic presentations, but some of the options available with only electronic presentations (eg, building, transitioning, and sound) necessitate new "rules." The article provides tips on how to develop effective text and image slides for electronic presentation by using PowerPoint, including the appropriate use of text, font, color, sound, graphics, slide display, and radiologic images.
The adult education literature supports the idea that teaching adults should be approached in a different way than teaching children and adolescents (preadults). Many aspects of effective teaching apply to all age groups. However, adults have had more life experiences and in many ways are differently motivated than children. Adults are more self-directed in their learning and have a greater need to know why they should learn something. Self-initiated learning is the most lasting and pervasive. Learning should be applicable to the learner's work or to other responsibilities valued by the learner. Thus, it is important that the instructor know the learner's needs and design learning activities that are relevant to those needs. The learner should be actively involved in learning, with the instructor acting as a facilitator. The instructor should recognize that adults have different learning styles and should tailor instruction to the characteristic ways adults prefer to learn. Understanding the principles of adult learning can help teachers become better facilitators of learning.
Dual-energy subtraction chest radiography is a robust and powerful tool that improves the ability to detect and accurately diagnose a wide variety of thoracic abnormalities on posteroanterior-lateral chest images. Dual-energy subtraction chest radiography has many advantages over conventional chest radiography that facilitate image interpretation. The major advantage of this imaging technique is that it more clearly depicts calcification, which greatly aids in characterizing pulmonary nodules. Dual-energy subtraction images are also helpful in the recognition of hilar and mediastinal masses; the detection of tracheal narrowing and vascular disease; the identification of bone, pleural, and chest wall abnormalities; and the localization of indwelling devices such as stents and catheters. However, dual-energy subtraction imaging also has some limitations of which the radiologist should be aware and requires a somewhat higher radiation dose than does conventional radiography.