Radiology Commons^™

Application Of Lean Six Sigma Strategies To Improve Diagnostic Imaging Departmental Performance Metrics: A Literature Review, Obinna Newman Osuji

Radiologic Sciences

Purpose To systematically evaluate the effectiveness of Lean and Six Sigma quality improvement approaches in enhancing diagnostic imaging workflows and departmental financial performance.

Method Literature for this review was retrieved from Scopus, CINAHIL Plus, PubMed, and Healthcare Administration Database in February and March 2026. Empirical studies and literature reviews were included if they addressed the utilization of Lean Six Sigma, Lean, or Six Sigma as a method of quality improvement within a diagnostic imaging departmental setting.

Results Database searches generated 1,624 articles, and 17 were deemed suitable for inclusion in the study. There were four studies that directly measured patient …

Assault Vs. Assistance: Radiologic Technologist Decision-Making When Fall-Risk Patients Decline Assistance, Pamela O'Dowd

Radiologic Sciences

Purpose To explore how radiologic technologists experience and respond to situations involving fall-risk patients who decline assistance during imaging procedures.

Method A cross-sectional survey design was used to collect data from practicing radiologic technologists recruited through the American Society of Radiologic Technologists. Descriptive statistics, including frequencies and percentages, were analyzed using SPSS to summarize participant responses, and a thematic analysis was conducted on open-ended responses.

Results A total of 87 respondents completed the survey. Results indicated that encounters with fall-risk patients who refuse assistance are common in clinical imaging practice. Sixty-three (72.4%) technologists reported having experienced situations in which a …

Magnetic Resonance In Pregnancy: Safety Considerations, Contrast Risks, And Imaging Modality Alternatives, Lizzette Valdez

Radiologic Sciences

Purpose To examine the safety of magnetic resonance (MR) during pregnancy by evaluating fetal outcomes, contrast agent risks, and the comparative roles of MR, ultrasound, and computed tomography (CT) in prenatal imaging.

Method A literature review was conducted using PubMed and peer-reviewed radiology journals to identify studies evaluating MR safety during pregnancy. The review examined fetal and neonatal outcomes following prenatal MR exposure, trimester-specific imaging considerations, risks associated with gadolinium-based contrast agents, and comparisons among MR, ultrasound, and CT.

Results Three primary themes emerged: (a) noncontrast MR demonstrated a strong safety profile with no consistent association with adverse fetal or …

Comparing Ai-Generated And Human-Written Radiology Reports: Evidence From The Literature, Lakenya Webb

Radiologic Sciences

Purpose To evaluate the current evidence comparing artificial intelligence (AI)-generated radiology reports with radiologist-written reports, emphasizing diagnostic accuracy, clinical reasoning, workflow efficiency, and patient safety.

Method A literature review was performed using peer-reviewed articles identified through The University of Texas MD Anderson Cancer Center Research Medical Library. Studies evaluating AI-generated radiology reports were analyzed using AI-assisted thematic synthesis to identify recurring patterns related to report quality, diagnostic performance, and clinical implementation.

Results The literature consistently identified three overarching themes: (a) AI-generated reports demonstrated improvements in structured reporting and factual consistency but exhibited variable diagnostic accuracy; (b) current AI systems had …

Deep Learning Reconstruction In Pediatric Ct Imaging, Cody Wyatt

Radiologic Sciences

Purpose To synthesize current evidence on dose optimization using deep learning reconstruction (DLR) with emphasis on computed tomography (CT), pediatrics, contrast to noise ratio (CNR), signal to noise ratio (SNR), and radiation dosage.

Method The methodology was a systematic literature review, synthesizing peer-reviewed literature on the use of DLR in pediatric CT. Databases searched included Scopus, IEEE Xplore, and Web of Science. Keywords include combinations of deep learning reconstruction, DLR, CT, pediatric, dose, and optimization. Boolean operators were used to refine search results.

Results Three themes emerged: dosage reduction, noise reduction, and improved spatial resolution with the use of DLR …

National Pacs And Electronic Health Records: Considerations, Challenges, And Implications For Radiomics, Darchelle Scott

Radiologic Sciences

Purpose To examine the considerations, challenges, and implications of implementing a national picture archiving and communication system (PACS) integrated with electronic health records (EHRs), with particular emphasis on interoperability, radiomics, and patient-centered data sharing.

Method A systematic literature review was conducted using books, peer-reviewed articles, original research studies, and government publications addressing radiomics, TEFCA, blockchain technology, PACS, and EHR integration. Literature was analyzed to evaluate national health information exchange, radiomics applications, and implementation challenges associated with a connected healthcare infrastructure.

Results Three primary themes emerged: (a) interoperable national PACS and EHR systems have the potential to improve continuity of care …

Ai-Driven Segmentation And Volumetric Response Modeling Of Liver Regions To Radiotherapy, Aashish Chandra Gupta

Dissertations and Theses (Open Access)

In liver-directed radiotherapy (RT), liver regions receiving higher doses typically undergo atrophy while contralateral/adjacent lower-dose regions may exhibit compensatory hypertrophy through regeneration of healthy tissue. Optimizing the RT plan to promote regional hypertrophy while minimizing the risk of developing atrophy has the potential to enhance post-RT liver function and long-term survivorship. However, current clinical practice largely relies on global liver dose-volume metrics during RT-planning, which may obscure favorable dose-response correlation and limit actionable guidance for clinicians. Therefore, we hypothesized that post-RT regional liver response is governed by a combination of region-specific dose-volume and patient clinical features, and that these responses …

Developing A Deep-Learning Model To Segment White Matter Lesions In Cerebral Palsy, Varsha Kumar, Hyukjin Yun, Rose N. Gelineau-Morel, Avner Meoded

Posters

No abstract provided.

A Misplaced Pocket Of Air: Intramural Gastric Air Most Consistent With Gastric Emphysema, Priyanka Panwar, Lavender Otom, Subo Marsa, Gerald Odong, Steven Idet, Irene Muchiri, Hussein Abdulsamad, John Odhiambo, Christopher Opio, Amos Mwasamwaja, Saleem Abdulkarim

Internal Medicine, East Africa

Background Gastric emphysema (GE), or gastric pneumatosis, is a rare, noninfectious cause of intramural gastric air that must be distinguished from emphysematous gastritis (EG), a highly lethal infectious entity. Despite similar radiographic appearances, these conditions differ substantially in etiology, clinical course, management, and prognosis.

Cases We report three hemodynamically stable patients with CT-confirmed intramural gastric air most consistent with GE. Two had associated portal venous gas. The cases occurred in distinct clinical contexts: infectious gastroenteritis with retching, transient midgut volvulus with obstructive gastric overdistension, and alcohol-related upper gastrointestinal bleeding with forceful vomiting and a Mallory–Weiss tear. Although early EG could …

Computed Tomography Findings Of Normal Appendix In Pediatric Population, Thanwarat Koonthong, Teerasak Phewplung*

Chulalongkorn Medical Journal

Background: Appendicitis remains the most common indication for emergency abdominal surgery in children. Computed tomography (CT) plays a vital role in the evaluation of pediatric patients with suspected appendicitis. Yet, there is limited of literature describing the normal appendiceal diameter in the pediatric Asian population.

Objectives: To characterize the normal pediatric appendix and to identify the variables that influence its diameter in pediatric patients aged one day to 18 years who underwent abdominal CT.

Materials and Methods: The study was approved by the IRB. We conducted a retrospective study of 358 children (≤18 years of age) who underwent abdominal CT …

Hiding In Plain Sight: A Case Of Intestinal Tuberculosis Masquerading As Benign Lower Gi Bleeding, Lavender Otom, Priyanka Panwar, Gerald Odong, Fatma Kassim, Patricia Okiro, Christopher Opio, Saleem Abdulkarim

Internal Medicine, East Africa

Background Intestinal tuberculosis (TB) represents the most common form of abdominal TB, often affecting the ileocaecal region. Lower gastrointestinal bleeding is an uncommon presentation and may create significant diagnostic uncertainty, particularly in immunocompromised patients and in settings where inflammatory bowel disease is also encountered.

Case Presentation A woman in her sixties from Africa presented with recurrent diarrhoea and intermittent haematochezia over a 6-month period. Initial endoscopic evaluation was nondiagnostic. Cross-sectional imaging later demonstrated multifocal bowel involvement affecting both the small and large bowel, including ileocaecal and rectoanal disease, with associated abdominopelvic lymphadenopathy. Histopathology from repeat colonoscopy biopsy showed caseating granulomas …

Fractured Focus: Understanding Stress In Second-Year Radiologic Science Students Across Alabama, Kelsi Clotfelter

Honors Theses

Higher education is a period of rapid transition and growing responsibility, where stress often becomes a routine part of students’ lives. In health professional programs, the combined demands of intensive coursework and clinical training can intensify emotional strain and negatively affect overall well-being. Radiography students experience uniquely high levels of academic, clinical, and emotional stress due to the simultaneous demands of didactic coursework, competency-based clinical training, and high-stakes professional expectations. A cross-sectional mixed-methods study was employed to evaluate the prevalence, sources, and perceived impact of stress among second-year radiography students across multiple Alabama institutions with the goal of identifying strategies …

Hypovascular Aggressive Angiomyxoma In A Pregnant Adolescent: A Case Report And Review Of Its Multimodal Imaging Appearances, Kyler Shin, Kweku Agyepong, Craig Kym, Mohammad Ghasemi-Rad, David Léon

Faculty, Staff and Students Publications

Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor that primarily arises in the perineum and pelvis of young females. It is sometimes identified incidentally on pelvic examination and obstetric imaging. Although asymptomatic at small sizes, AAM is typically hypervascular and can grow large enough to complicate a patient's obstetric and gynecologic course of treatment. While AAM is a rare diagnosis reported in the literature, there are limited descriptions of its multimodal radiologic appearance, and uncommonly, it can present as a hypovascular mass. We describe a rare case of hypovascular AAM in pregnancy that did not respond favorably to targeted embolization, …

Regional Hemodynamic Characterization Of The Thoracic Aorta Using 4d Flow Mri: A Single-Center Pilot Study, John H. Major

Summer Research Program Abstracts

No abstract provided.

Ai-Segmented Upper Airway Imaging Biomarkers Across The Lifespan, David L. Holt, Vishwa S. Parekh

Summer Research Program Abstracts

No abstract provided.

Population-Level Eligibility For Bonemri As A Radiation-Free Alternative To Spine Ct, Niels Levy-Thiebaut, Timothy Borden Md

Summer Research Program Abstracts

No abstract provided.

Blinded, Bias-Controlled Multi-Rater Evaluation Of Human-Versus-Ai Brain Metastasis Segmentation Using A Hybrid Foundation-Model Framework, Yiding Han, Enze Zhu, Mhd Hasan Ai Mekdash, Omar Awad, Piyush Pathak, Shixiao Liang, Daniel Allan Hamstra, Xizhe Zhang, Zaid Ali Siddiqui, Baozhou Sun

Faculty, Staff and Students Publications

Background: Accurate segmentation of brain metastases (BM) is essential for diagnosis, stereotactic radiosurgery planning, and longitudinal assessment. However, manual contouring is time-intensive, limiting clinical scalability, and exhibits substantial inter-observer variability. This variability complicates objective assessment of automated segmentation methods and challenges interpretation of model performance.

Purpose: To address these limitations, we developed TUM-SAM, a hybrid foundation-model framework for fully automated BM segmentation, and introduced a bias-controlled, blinded multi-rater evaluation paradigm to determine whether AI-based BM segmentation has reached expert-level performance and whether AI-generated contours are preferred by human experts under unbiased assessment.

Methods: TUM-SAM integrates nnU-Net-based lesion detection with a …

Letter To The Editor: Hemodynamic Role In Hepatic Encephalopathy Pathogenesis Following Transjugular Intrahepatic Portosystemic Shunt Placement, John Halphen, Yash S Dayal, Cameron Laurie, Mohadese Ahmadzade, David Wynne, Mohammad Ghasemi-Rad

Faculty, Staff and Students Publications

Hepatic encephalopathy (HE) is a common complication following transjugular intrahepatic portosystemic shunt (TIPS) placement and is thought to result from reduced hepatic detoxification of neurotoxins. However, Zhuang et al in the World Journal of Radiology demonstrate that this understanding may be incomplete through exploration of the pathophysiology from a hemodynamic perspective. They found significant changes in cerebral blood flow (CBF) and spontaneous brain activity following TIPS. Initially, CBF increased in specific areas within the first month, followed by a return to baseline at three months. These CBF changes coincided with increased spontaneous brain activity that persisted in some areas, suggesting …

Imaging And Non-Imaging Approaches For The Diagnosis And Monitoring Of Necrotizing Enterocolitis-What Lies Ahead?, Indrani Bhattacharjee, Catalina Le Cacheux, Eric B. Ortigoza, Jonathan Dillman, Sherwin S. Chan, Alain Cuna

Manuscripts, Articles, Book Chapters and Other Papers

Necrotizing enterocolitis (NEC) remains one of the most serious gastrointestinal emergencies in preterm infants, and imaging plays a central role in diagnosis and clinical management. Historically, evaluation has relied primarily on abdominal radiography, which remains widely available and embedded in established diagnostic frameworks. However, the hallmark radiographic signs of NEC (i.e., pneumatosis intestinalis, portal venous gas, and free air) reflect relatively advanced manifestations of intestinal injury that indicate established mucosal disruption or transmural necrosis. Bowel ultrasound has increasingly complemented radiography by enabling real-time assessment of bowel wall integrity, perfusion, motility, and intra-abdominal fluid, providing physiologic information that may refine clinical …

A Novel Qa Method For Adaptive Aperture Position Verification Of Proton Therapy System, Shuxin Fan, Tiezhi Zhang, Xiandong Zhao, Winter Green, Baozhou Sun, Tianyu Zhao, Yao Hao

Faculty, Staff and Students Publications

Accurate Adaptive Aperture (AA) leaf positioning is essential for some proton therapy systems to ensure precise dose delivery and patient safety. However, conventional quality assurance (QA) methods can be suboptimal or inefficient for routinely assessing the dynamic nature of AA in the Mevion S250i HYPERSCAN system. This study introduces a novel automated QA method to verify AA positions utilizing a scintillation detector. A specialized QA plan consisting of 7 rectangular fields was generated in the RayStation treatment planning system (TPS) and delivered using the Mevion S250i HYPERSCAN proton therapy system. Dose distributions were measured with an IBA Lynx PT scintillation …