The edition · Radiology
A three-week rule moved symptomatic breast imaging forward
A scheduling guideline shortened waits for women with worrying breast symptoms, a critique explains why prostate MRI AI looks better than it is, contrast reactions get a price and a time cost, and a benign femoral pattern in older women is described.
The edition in brief
After a multisite US system required high-priority diagnostic breast imaging within three weeks of the order, three-week completion rose from 57.4% to 65.3% across 70,823 examinations, and symptomatic patients, who had been waiting longest, saw the largest gain (61.1% vs 49.5%). A European Radiology perspective sets out six domains - reference standard, spectrum and pathway bias, comparator choice and others - that can make prostate MRI AI tools appear near-perfect for reasons unrelated to the algorithm. A five-year single-centre study of more than 600,000 contrast-enhanced CT and MR examinations found acute reactions cost little in the median case but added about 25 minutes of department time, with severe reactions and admissions far more costly. Thirty older women with bilateral distal femoral sclerotic lesions shared a consistent, non-aggressive pattern linked to fat necrosis and dystrophic calcification, which may spare some biopsies once confirmed. The pearl covers contrast reaction readiness.
Why prostate MRI AI often looks better than it is
Before adopting a prostate MRI AI tool, check its validation cohort, reference standard and comparator - near-perfect accuracy is usually a design artefact.
Acute contrast reactions: cheap in the median, costly at the tail, and slow
Plan for contrast reactions as a workflow event: most are minor, but each takes about 25 minutes and the rare severe one is costly.
Bilateral distal femoral sclerosis in older women: a benign pattern described
Bilateral, mostly lateral distal femoral sclerosis with fat-signal marrow in an older woman may be benign fat necrosis - consider it before escalating work-up.
Rehearse the contrast reaction before it happens
Treat suspected contrast anaphylaxis with intramuscular adrenaline first, and drill the team so no one hesitates.
A three-week target sped up diagnostic breast imaging for symptomatic patients
Consider a defined high-priority category with a three-week target for symptomatic breast imaging, and audit whether symptomatic women are waiting longest.
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