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Research Studies is a compilation of published research articles funded by ´óÏóAPPor authored by ´óÏóAPPresearchers.

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1 to 25 of 273 Research Studies Displayed
Scott Wang HH, Hatoun J, Xu J
Adherence to urologic imaging guidelines after febrile urinary tract infection in infants.
This study investigated practice pattern variability and associated factors in pediatric febrile UTI (fUTI) imaging in primary care clinics. In 2011 the American Academy of Pediatrics created guidelines which recommended renal bladder ultrasound (RBUS) after fUTI and voiding cystourethrogram (VCUG) after abnormal RBUS or second fUTI. Overall, post-UTI imaging was adherent to the AAP guideline in 82 cases. Significant predictors of guideline adherence were commercial insurance, more providers in the practice, and younger provider age after adjusting for patient's age, sex, maximal temperature during fUTI.
AHRQ-funded; HS029526.
Citation: Scott Wang HH, Hatoun J, Xu J . Adherence to urologic imaging guidelines after febrile urinary tract infection in infants. J Pediatr Urol 2025 Jun; 21(3):700-05. doi: 10.1016/j.jpurol.2025.02.024..
Keywords: Newborns/Infants, Urinary Tract Infection (UTI), Imaging, Guidelines
Wang HS, Cheng AD, Cai J
Practice variation and guideline compliance in urologic imaging after initial urinary tract infection in children.
This study’s objective was to investigate practice variability and drivers of imaging after febrile UTI (fUTI). The primary outcome was compliance with American Academy of Pediatrics (AAP) guidelines regarding genitourinary (GU) imaging after the first or second fUTI, and secondary outcomes were whether patients received GU imaging and the timing of voiding cystourethrogram (VCUG). Overall adherence to the AAP guidelines was 41%. Thirty-two percent of patients received no GU imaging. Compliance was associated with younger age and inpatient treatment. The receipt of any imaging was associated with younger age, female patients, inpatient treatment, and private insurance.
AHRQ-funded; HS029526.
Citation: Wang HS, Cheng AD, Cai J . Practice variation and guideline compliance in urologic imaging after initial urinary tract infection in children. Urology 2025 Jun; 200:191-97. doi: 10.1016/j.urology.2025.04.025..
Keywords: Children/Adolescents, Urinary Tract Infection (UTI), Imaging, Guidelines
Mangus CW, Janke AT, Mahajan P
MRI adoption in pediatric appendicitis: trends and outcomes.
The objective of this retrospective cohort study was to describe magnetic resonance imaging (MRI) adoption trends and to evaluate the association of MRI adoption with appendicitis complications. Subjects were pediatric patients less than 19 years old with appendicitis at pediatric emergency departments. Findings indicated that children's hospitals have slowly adopted MRI for appendicitis, but most still rely on computed tomography.
AHRQ-funded; HS026503; HS029523.
Citation: Mangus CW, Janke AT, Mahajan P . MRI adoption in pediatric appendicitis: trends and outcomes. Hosp Pediatr 2025 May; 15(5):416-22. doi: 10.1542/hpeds.2024-008077..
Keywords: Children/Adolescents, Surgery, Imaging
Brink FW, Adler B, Bambach S
Using deep learning for estimation of time-since-injury in pediatric accidental fractures.
The purpose of this study was to develop artificial intelligence tools for more accurately determining when pediatric bone fractures occurred. Researchers analyzed radiographic images of accidental long bone fractures from 399 children under age six treated at a Midwestern children's hospital. They created deep learning models to both classify fractures into different age groups and directly estimate fracture age. The research team evaluated model performance through various metrics including confusion matrices and error measurements. Their best-performing model could estimate fracture age for any long bone with a mean absolute error of 6.2 days, with 68% of estimates falling within one week of the actual fracture age. This represents significant improvement over current fracture dating methods, which often provide only broad timeframes.
AHRQ-funded; HS028847.
Citation: Brink FW, Adler B, Bambach S . Using deep learning for estimation of time-since-injury in pediatric accidental fractures. Pediatr Radiol 2025 May; 55(6):1257-69. doi: 10.1007/s00247-025-06223-4..
Keywords: Children/Adolescents, Injuries and Wounds, Imaging
Vissa M, Parikh P, McCulloch C
Improving completion rates of transcranial doppler ultrasounds in children with sickle cell disease using quality improvement efforts: in-clinic versus population-based assessments.
Transcranial Doppler (TCD) screening has been found to be essential for stroke prevention in children with sickle cell disease (SCD), but national screening rates are low. This study used Medicaid administrative claims to assess TCD completion rates before and after a 12-month quality indicator (QI) initiative to improve rates in the Pacific Sickle Cell Regional Collaborative (PSCRC). The authors found an increase in TCD screening rates for QI participant sites (52.4% to 58.6%), but not for the nonparticipant SCD population (48.3% to 38.3%). The increase in QI participant sites was not sustained 1 year after the end of the initiative. They suggest that local clinic-level QI initiatives may need to be supplemented with health system partnerships to sustain higher TCD screening rates, thereby improving SCD outcomes.
AHRQ-funded; HS025297.
Citation: Vissa M, Parikh P, McCulloch C . Improving completion rates of transcranial doppler ultrasounds in children with sickle cell disease using quality improvement efforts: in-clinic versus population-based assessments. Pediatr Blood Cancer 2025 Apr; 72(4):e31549. doi: 10.1002/pbc.31549..
Keywords: Children/Adolescents, Sickle Cell Disease, Quality Improvement, Quality of Care, Imaging, Diagnostic Safety and Quality
Guenette JP, Lee J, Haneuse S
Patient photograph association with radiologist recommendations for additional imaging.
The purpose of this study was to assess whether displaying patient photographs in electronic health records affects radiologists' recommendations for additional imaging, and whether certain demographics modify this association. This retrospective study analyzed 60,543 head and neck CT or MRI reports from 48,143 patients across a multi-institution healthcare system. Patient photographs were displayed for 18.2% of reports, and 7.5% of reports included recommendations for additional imaging. After adjusting for multiple factors including age, sex, complexity score, race, and area deprivation index, reports signed when a photograph was displayed had significantly lower odds of containing recommendations for additional imaging.
AHRQ-funded; HS029348; HS029839.
Citation: Guenette JP, Lee J, Haneuse S . Patient photograph association with radiologist recommendations for additional imaging. J Am Coll Radiol 2025 Apr; 22(4):478-85. doi: 10.1016/j.jacr.2024.10.018.
Keywords: Imaging, Diagnostic Safety and Quality
Lin Y, Hoyt AC, Manuel VG
Risk-stratified screening: a simulation study of scheduling templates on daily mammography recalls.
This simulation study assessed the potential impact of risk-stratified screening (RSS) scheduling on patients recommended for same-day diagnostic testing for potentially abnormal mammograms. The RSS design sequences patients in the screening schedule using cancer risk categories developed from Tyrer-Cuzick and deep learning model scores. The results suggested that RSS scheduling could reduce variance in follow-up appointments.
AHRQ-funded; HS029257.
Citation: Lin Y, Hoyt AC, Manuel VG . Risk-stratified screening: a simulation study of scheduling templates on daily mammography recalls. J Am Coll Radiol 2025 Mar; 22(3):297-306. doi: 10.1016/j.jacr.2024.12.010..
Keywords: Imaging, Screening, Cancer: Breast Cancer, Cancer
Alpert E, Wood JN, Shults J
Variation in use of neuroimaging in the care of infants undergoing subspecialty evaluations for abuse: a multicenter study.
The purpose of this cross-sectional study was to quantify hospital-level differences in the utilization of neuroimaging to evaluate for intracranial injury in infants undergoing subspecialty evaluations for physical abuse who did not show symptoms of head trauma. Variations were not linked to race/ethnicity or insurance type but were associated with younger age, rib fractures, and hospital practices, suggesting a need for standardized care guidelines.
AHRQ-funded; HS028847.
Citation: Alpert E, Wood JN, Shults J . Variation in use of neuroimaging in the care of infants undergoing subspecialty evaluations for abuse: a multicenter study. Acad Pediatr 2025 Mar; 25(2):102597. doi: 10.1016/j.acap.2024.10.009..
Keywords: Newborns/Infants, Imaging, Brain Injury, Trauma
Lange JM, Gard CC, O'Meara ES
Breast density and risk of breast cancer: masking and detection bias.
Using data from women in the Breast Cancer Surveillance Consortium, researchers investigated the association between breast density and breast cancer risk. The results of sensitivity analyses suggested that higher breast density is robustly associated with increased risk of breast cancer onset, similar in magnitude to increased risk of breast cancer diagnosis.
AHRQ-funded; HS018366.
Citation: Lange JM, Gard CC, O'Meara ES . Breast density and risk of breast cancer: masking and detection bias. Am J Epidemiol 2025 Feb 5; 194(2):441-48. doi: 10.1093/aje/kwae245..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Imaging, Diagnostic Safety and Quality
Baird TA, Previtera M, Brady S
A scoping review of risk presentation in patient decision aids: communicating risk in imaging.
The purpose of this study was to conduct a scoping review of patient decision aids in medical imaging and describe the presentation techniques of imaging risks. The authors found inconsistent communication of risks. Most aids presented risks in text form, with visual formats like icon arrays used less consistently. This variability may impact patient decision-making, particularly for those with lower health literacy.
AHRQ-funded; HS026393.
Citation: Baird TA, Previtera M, Brady S . A scoping review of risk presentation in patient decision aids: communicating risk in imaging. J Am Coll Radiol 2025 Feb; 22(2):172-82. doi: 10.1016/j.jacr.2024.05.014..
Keywords: Imaging, Risk, Communication, Clinician-Patient Communication
Giess CS, Lynch E, Lacson R
Patient, examination, and system factors associated with completed follow-up for probably benign (BI-RADS 3) breast findings in a large, complex health care system.
This retrospective study examined factors associated with completed follow-up imaging for probably benign (BI-RADS 3) breast findings across a large healthcare system in 2021. Among 8,834 examinations, 76.7% had completed follow-up within 15 months. Multivariable analysis identified several factors associated with incomplete follow-up: ultrasound or MRI examinations versus mammography, Asian race, age under 40, non-married status, public insurance or self-pay status, delayed order placement, and orders placed by non-primary care providers. Contrary to expectations, socioeconomic disadvantage measured by area deprivation index was not associated with incomplete follow-up. These findings identify specific patient demographics and system factors that could be targeted to improve adherence to recommended imaging follow-up.
AHRQ-funded; HS029348.
Citation: Giess CS, Lynch E, Lacson R . Patient, examination, and system factors associated with completed follow-up for probably benign (BI-RADS 3) breast findings in a large, complex health care system. Acad Radiol 2025 Feb; 32(2):681-90. doi: 10.1016/j.acra.2024.09.037..
Keywords: Imaging, Screening, Women, Cancer: Breast Cancer, Cancer
Plimpton SR, Milch H, Sears C
External validation of a commercial artificial intelligence algorithm on a diverse population for detection of false negative breast cancers.
The objective of this retrospective study was to evaluate the ability of AI to detect false negative cancers that were not detected at the time of screening. An AI algorithm was applied to patients who had undergone screening full-field digital mammography (FFDM) or digital breast tomosynthesis (DBT) at one institution. AI was able to detect cancers that were missed by the radiologist; the authors concluded that studies were needed to evaluate the synergy of AI and radiologists in real-world settings, especially on DBT examinations.
AHRQ-funded; HS029257.
Citation: Plimpton SR, Milch H, Sears C . External validation of a commercial artificial intelligence algorithm on a diverse population for detection of false negative breast cancers. J Breast Imaging 2025 Jan 25; 7(1):16-26. doi: 10.1093/jbi/wbae058..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Health Information Technology (HIT)
Starnes JR, Weiner JG, George-Durrett K
Boys with Duchenne muscular dystrophy have diastolic dysfunction based on CMR.
This case-control study looked at cardiomyopathy in boys with Duchenne muscular dystrophy (DMD), which is their leading cause of death. Patients with DMD (n = 179) and healthy controls (n = 96) were prospectively enrolled and underwent cardiac magnetic resonance (CMR). Patients with DMD had significantly smaller stature and ventricular volumes than healthy control patients. They had lower baseline left ventricular (LV) ejection fraction, though most had normal systolic function. When adjusted for age, sex, heart rate, body surface area, and LV end-diastolic volume, patients with DMD had slower peak filling rates and peak ejection rates, as well as slower time to peak ventricular ejection rate. When adjusted for heart rate, a lower peak ventricular ejection rate and peak filling rate, normalized to LV end-diastolic volume, was associated with mortality in patients with DMD.
AHRQ-funded; HS026122.
Citation: Starnes JR, Weiner JG, George-Durrett K . Boys with Duchenne muscular dystrophy have diastolic dysfunction based on CMR. Circ Cardiovasc Imaging 2024 Dec; 17(12):e017287. doi: 10.1161/circimaging.124.017287.
Keywords: Imaging, Heart Disease and Health, Surgery, Children/Adolescents, Neurological Disorders, Mortality
Rosovsky RP, Isabelle M, Abbasi N
CT pulmonary angiogram clinical pretest probability tool: impact on emergency department utilization.
The purpose of this study was to assess the impact of an evidence-based clinical decision support (CDS) tool intended to optimize appropriate use of computed tomographic pulmonary angiogram (CTPA) for evaluating acute pulmonary embolism (PE). The study was performed at emergency departments in a large healthcare system including nine academic and community hospitals. The results showed that implementation of a CDS based on validated decision rules was associated with a significant reduction in CTPA utilization.
AHRQ-funded; HS028616.
Citation: Rosovsky RP, Isabelle M, Abbasi N . CT pulmonary angiogram clinical pretest probability tool: impact on emergency department utilization. J Am Coll Radiol 2024 Dec; 21(12):1851-61. doi: 10.1016/j.jacr.2024.07.024.
Keywords: Imaging, Emergency Department, Healthcare Utilization, Cardiovascular Conditions
Fenton JJ, Cipri C, Gosdin M
Standardized patient communication and low-value spinal imaging: a randomized clinical trial.
This randomized clinical trial’s objective was to evaluate the effect of a standardized patient-delivered intervention on rates of low-value spinal imaging among primary care patients with acute low back pain. Physicians or advanced practice clinicians were recruited from 10 adult primary care or urgent care clinics. The intervention clinician group received 3 simulated office visits, each with a standardized patient instructor (SPI) portraying a patient with acute uncomplicated back pain. Primary outcome was lumbar spinal imaging completion within 90 days of acute low back pain visits, with study clinicians assessed up to 18 months of follow-up. The secondary outcomes were cervical spine imaging completion after acute neck pain visits, any imaging completion after an adult visit, patient experience ratings of clinicians, and use of targeted communication skills during an audio-recorded standardized patient evaluation visit. A total of 53 clinicians were included, with 25 in the intervention group, and 28 in the control group. Patients with acute low back pain who saw intervention and control clinicians during follow-up had similar rates of lumbar imaging. Adjusted follow-up rates of imaging for acute neck pain and overall imaging were not significantly different among patients of intervention and control clinicians. Intervention and control clinicians had similar mean (SD) patient experience ratings during follow-up. During audio-recorded standardized patient visits, intervention clinicians had significantly better ratings than controls on eliciting the patient's perspective and conveying empathy.
AHRQ-funded; HS026415.
Citation: Fenton JJ, Cipri C, Gosdin M . Standardized patient communication and low-value spinal imaging: a randomized clinical trial. https://www.pubmed.ncbi.nlm.nih.gov/39504026.
Keywords: Communication, Imaging, Back Health and Pain, Primary Care, Pain
Montgomery KB, Duncan ZN, Holder AM
Interdisciplinary implementation of a synoptic reporting template for melanoma nodal surveillance ultrasound.
To address the low utilization of Second Multicenter Selective Lymphadenectomy Trial (MSLT-II) nodal ultrasonography criteria to define abnormal lymph nodes requiring intervention or biopsy, an evidence-based synoptic template was designed and implemented in a single-center study. Nearly all surgeon and radiologist survey respondents were satisfied with the clinical utility of the synoptic template. Following implementation, ultrasonography reports were significantly more likely to document MSLT-II criteria and provide an actionable recommendation, increasing usefulness to providers.
AHRQ-funded; HS013852.
Citation: Montgomery KB, Duncan ZN, Holder AM . Interdisciplinary implementation of a synoptic reporting template for melanoma nodal surveillance ultrasound. Ann Surg Oncol 2024 Nov; 31(12):8222-29. doi: 10.1245/s10434-024-15630-0.
Keywords: Imaging, Cancer: Skin Cancer, Cancer
Leotta DF, Anderson M, Straccia A
Measurement of transcranial Doppler insonation angles from three-dimensional reconstructions of CT angiography scans.
This article described a 3-D vessel model developed by the authors, generated from computed tomography angiography (CTA) scans to measure Doppler angles in the basal cerebral arteries examined with Transcranial Doppler (TCD). The approach used in this model produced angle statistics not accessible during non-imaging TCD studies. The authors created 3D models of the basal cerebral arteries for 24 vasospasm patients to test the model: angle measurements indicated that expected deviation between measured and true velocities in the cerebral arteries highlighted specific segments that may be prone to underestimation of velocity.
AHRQ-funded; HS026690.
Citation: Leotta DF, Anderson M, Straccia A . Measurement of transcranial Doppler insonation angles from three-dimensional reconstructions of CT angiography scans. J Clin Monit Comput 2024 Oct; 38(5):1101-15. doi: 10.1007/s10877-024-01187-6..
Keywords: Imaging, Cardiovascular Conditions
Lacson R, Haj-Mirzaian A, Burk K
A model for predicting clinically significant prostate cancer using prostate MRI and risk factors.
The goal of this study was to develop and validate a predictive model for clinically significant prostate cancer (csPCa) by using MRI and patient risk factors. Men diagnosed with csPCa were identified from a population who underwent MRI. Variables that predicted csPCa were Prostate Imaging Reporting and Data System scores of 4 and 5, the presence of extra-prostatic extension, and elevated prostate-specific antigen (PSA) density. The authors concluded that the point-based model used in this study had the potential to identify increased numbers of men at risk for csPCa, while avoiding biopsy in about 20% of men with elevated PSA levels.
AHRQ-funded; HS029348.
Citation: Lacson R, Haj-Mirzaian A, Burk K . A model for predicting clinically significant prostate cancer using prostate MRI and risk factors. J Am Coll Radiol 2024 Sep; 21(9):1419-27. doi: 10.1016/j.jacr.2024.02.035..
Keywords: Cancer: Prostate Cancer, Cancer, Imaging, Screening, Risk
Byrne SC, Peers C, Gargan ML
Risk of malignancy in incidentally detected lung nodules in patients aged younger than 35 years.
This study’s goal was to evaluate the incidence of lung cancer in incidental pulmonary nodules in patients who are 15-34 years old. Patients in this retrospective cohort study had an incidental pulmonary nodule on chest CT from 2010 to 2018. A total of 5,355 chest computed tomographies (CTs) were performed from 2010 to 2018. 779 patients were left in the study after excluding patients without a reported pulmonary nodule and prior or current malignancy. Of those 70% had imaging or clinical follow-up greater than 2 years after their initial imaging. A malignant diagnosis was established in two (0.3%) of the 779 patients. Nodule size was strongly associated with malignancy, with area under the receiver operating characteristic curve of 0.97. No malignant nodules were less than 10 mm in size. Malignancy was associated with smoking history, number of nodules, and nodule density.
AHRQ-funded; HS029348.
Citation: Byrne SC, Peers C, Gargan ML . Risk of malignancy in incidentally detected lung nodules in patients aged younger than 35 years. J Comput Assist Tomogr 2024 Sep-Oct; 48(5):770-73. doi: 10.1097/rct.0000000000001592..
Keywords: Cancer: Lung Cancer, Cancer, Diagnostic Safety and Quality, Imaging
Couch E, Ashford MT, Prina M
Persons with cognitive impairment and care partner motivations and experiences of undergoing an amyloid scan: a systematic review of qualitative studies.
This review identified and summarized qualitative studies that explored the patient and care partner experiences of undergoing an amyloid scan. The authors identified four themes: Motivations for undergoing a scan; Experiences of receiving a result; Emotional responses to the result; Actions in light of the scan result. They concluded that amyloid scans can provide useful and actionable information, but note that learning scan results can be distressing for patients. Future research is needed to balance the potential benefits and harms of amyloid scans.
AHRQ-funded; HS000011.
Citation: Couch E, Ashford MT, Prina M . Persons with cognitive impairment and care partner motivations and experiences of undergoing an amyloid scan: a systematic review of qualitative studies. Gerontologist 2024 Aug; 64(8). doi: 10.1093/geront/gnae075..
Keywords: Neurological Disorders, Imaging, Dementia
Lin JK, Hearn CM, Getzen E
Validation of biomechanical computed tomography for fracture risk classification in metastatic hormone-sensitive prostate cancer.
This study looked at the fracture risk of men with metastatic hormone-sensitive prostate cancer (mHSPC) on androgen deprivation therapy (ADT). It evaluated the correlations between biomechanical computed tomography- (BCT-) and dual-energy x-ray absorptiometry- (DXA)-assessed bone mineral density (BMD) and associations between BCT-assessed metrics and subsequent fracture. This multicenter retrospective cohort study evaluated the associations between BCT-assessed metrics and subsequent fracture. Among 91 eligible patients, the median (interquartile range) age was 67 years (62-75), 44 (48.4%) were White, and 41 (45.1%) were Black. During the median follow-up of 82 weeks, 17 men (18.6%) developed a pathologic and 15 (16.5%) a nonpathologic fracture. BCT- and DXA-assessed femoral-neck BMD T scores were strongly correlated. Lower femoral strength (OR 1.63) was marginally associated with an increased risk of a pathologic fracture. Neither BMD (OR 1.52) nor strength (OR 1.14) was associated with a nonpathologic fracture. BCT identified nine men eligible for antiresorptive therapy, of whom four were not treated.
AHRQ-funded; HS026116.
Citation: Lin JK, Hearn CM, Getzen E . Validation of biomechanical computed tomography for fracture risk classification in metastatic hormone-sensitive prostate cancer. Eur Urol Oncol 2024 Aug; 7(4):794-803. doi: 10.1016/j.euo.2023.10.016..
Keywords: Cancer: Prostate Cancer, Imaging, Cancer
Knight LMJ, Tanabe P, Blewer AL
Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease.
This longitudinal study examined the prevalence and proportion of transcranial Doppler (TCD) screenings among North Carolina Medicaid enrollees with sickle cell disease (SCD), aged 2-16 years, from 2016 to 2019. The researchers investigated associations between TCD screenings, sociodemographic factors, and hydroxyurea (HU) adherence. The study found that annual TCD screening prevalence ranged from 39.5% to 40.1%. The proportion of children with two or more TCD claims increased with longer enrollment periods. Notably, children with good HU adherence were 2.48 times more likely to have TCD claims than those with poor adherence. The researchers used multivariable Poisson regression to assess TCD screening rates by HU adherence, controlling for age, sex, and rurality. Despite national guidelines recommending annual TCD screenings for children with SCD aged 2-16 years, overall screening prevalence remained low. However, children with better HU adherence and longer Medicaid enrollment tended to have more TCD screenings. The study concludes that multilevel interventions are necessary to engage healthcare providers and families in improving both evidence-based care and annual TCD screenings for children with SCD. These findings highlight the need for targeted strategies to increase adherence to recommended screening guidelines and improve overall care for this patient population.
AHRQ-funded; HS024501.
Citation: Knight LMJ, Tanabe P, Blewer AL . Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease. Pediatr Blood Cancer 2024 Jul; 71(7):e31017. doi: 10.1002/pbc.31017..
Keywords: Children/Adolescents, Sickle Cell Disease, Imaging
Lin Y, Hoyt AC, Manuel VG
MHS IV Rapid Review, Supply Chain Disruption; MHS IV Rapid Response, Nursing Staff Shortages
The purpose of this study was to evaluate the implementation of artificial intelligence-assisted mammogram interpretation to enable same-day diagnostic testing after abnormal screening results. Using computer simulation, researchers assessed how this workflow would affect a high-volume breast imaging center's operations. The analysis revealed that while the AI-aided approach could reduce unnecessary diagnostic procedures, it would lead to longer patient wait times and clinic stays, with a slight decrease in daily patient volume. The investigation identified potential solutions involving operational changes and additional resources to address these challenges.
AHRQ-funded; HS029257.
Citation: Lin Y, Hoyt AC, Manuel VG . MHS IV Rapid Review, Supply Chain Disruption; MHS IV Rapid Response, Nursing Staff Shortages AMIA Jt Summits Transl Sci Proc. 2024 May 31:2024:314-323..
Keywords: Health Information Technology (HIT), Women, Cancer: Breast Cancer, Cancer, Diagnostic Safety and Quality, Imaging, Workflow
Starnes JR, Xu M, George-Durrett K
Rate of change in cardiac magnetic resonance imaging measures is associated with death in duchenne muscular dystrophy.
The authors posited that identification of Duchenne muscular dystrophy (DMD) patients at risk of early cardiovascular disease (CVD) death could allow for increased monitoring and more intensive therapy; measures associated with death could serve as surrogate outcomes in clinical trials. Participants were DMD subjects prospectively enrolled in observational studies who had undergone multiple cardiac magnetic resonance imaging. DMD death was found to be associated with the rate of change in left ventricular ejection fraction, midcircumferential strain, and ventricular volumes. The authors concluded that aggressive medical therapy to decrease the rate of progression may improve mortality rates in this population, and that decrease in the rate of progression may serve as a valid surrogate outcome for therapeutic trials.
AHRQ-funded; HS026122.
Citation: Starnes JR, Xu M, George-Durrett K . Rate of change in cardiac magnetic resonance imaging measures is associated with death in duchenne muscular dystrophy. J Am Heart Assoc 2024 May 7; 13(9):e032960. doi: 10.1161/jaha.123.032960..
Keywords: Cardiovascular Conditions, Imaging
Kerlikowske K, Zhu W, Su YR
Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density.
This study compared using supplemental magnetic resonance imaging (MRI) with or without mammography to inform discussions about supplemental MRI in women with dense breasts. The authors evaluated 52, 237 women aged 40-79 years who underwent 2611 screening MRIs alone and 6518 supplemental MRI plus mammography pairs propensity score-matched to 65, 810 screening mammograms. They estimated rates per 1000 examinations of interval, advanced, and screen-detected early-stage invasive cancers and false-positive recall and biopsy recommendation by breast density (nondense = almost entirely fatty or scattered fibroglandular densities; dense = heterogeneously/extremely dense) adjusting for registry, examination year, age, race and ethnicity, family history of breast cancer, and prior breast biopsy. Screen-detected early-stage cancer rates were statistically higher for MRI plus mammography vs mammography for nondense (9.3 vs 2.9) and dense (7.5 vs 3.5) breasts and for MRI vs MRI plus mammography for dense breasts (19.2 vs 7.5). Interval rates were not statistically different for MRI plus mammography vs mammography for nondense (0.8 vs 0.5) or dense breasts (1.5 vs 1.4), nor were advanced cancer rates. MRI plus mammography had statistically higher false-positive recall and biopsy recommendation rates than mammography alone.
AHRQ-funded; HS018366.
Citation: Kerlikowske K, Zhu W, Su YR . Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density. J Natl Cancer Inst 2024 Feb 8; 116(2):249-57. doi: 10.1093/jnci/djad201.
Keywords: Imaging, Cancer

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