William W. Olmsted

The pathogenesis of peripheral aneurysms of the central nervous system: a subject review from the AFIP.

Most central nervous system aneurysms occur around the circle of Willis, and are congenital or arteriosclerotic in origin when in that location. Peripherally located aneurysms are either idiopathic or secondary to infection, tumor embolus (from choriocarcinoma and cardiac myxoma), Moyamoya disease, or trauma. The pathophysiologic features of these aneurysms are discussed.

Prognosis in Meningioma through Evaluation of Skull Bone Patterns

Sixty-three cases of meningioma were selected for study. Radiologically, they were divided into blastic and cystic groups. Tumors producing more blastic patterns infrequently recurred, unlike those that contained a lytic factor. The cases were also analyzed in regard to histologic type, but no relationship was found between histologic type and recurrence.

Cavernous Hemangioma of the Liver

In the differential diagnosis of hepatic lesions, age, vessel size and tapering, vessel displacement, arteriovenous shunting, the status of the veins, and neovascularity must be evaluated. Cavernous hemangioma should be considered in an adult patient when the vessels are normal in size and displaced away from the lesion, arteriovenous shunting is absent, the portal vein is normal, and prominent vascular lakes containing contrast material, which persists well into the venous phase, are seen. The differential diagnosis and pathophysiological explanation are presented.

A Resident Journal Club for Quality Improvement

An essential element in creating a safer health care environment and system is embedding the practice of quality into residency training. The ACGME’s core competencies and Health Professions Education Summit core areas can be used as guides for incorporating quality and safety education into residency training programs. We have conducted a literature review to build a reading list that residency program directors can use to improve quality and safety literacy within training programs, stimulate discussion and interest in quality and safety projects, and fulfill ACGME requirements on systemsased practice. Our goal was to nd highly relevant and educaional articles that apply princiles of quality management in ealth care. There have been challenges in he training of residents in quality ethodologies. Quality methodlogies have primarily arisen n manufacturing environments, nd it has been difficult to transate techniques and experiences nto health care. Tailoring and dapting concepts from modern anagement programs such as Lean nd Six Sigma into the service-intenive culture of health care is at least as mportant as the quality assurance rogram itself [1]. Fortunately, here has been a recent sharp rise in iterature incorporating quality ethodologies into health care, articularly in radiology. Another raditional challenge is that acaemic faculty members are generlly poorly trained in these methodlogies. The articles referenced elow can therefore be good entry

Conflict of interest disclosure in RSNA journals: adoption of the International Council of Medical Journal Editors Uniform Format.

The RSNA Board of Directors has approved adoption of the International Council of Medical Journal Editors’ uniform format for disclosure of conflicts of interest in articles published in RSNA journals.

Tips for Incorporating Quality Improvement Projects Into a Residency Program Curriculum

In February 2001, the ACGME endorsed systems-based practices as 1 of 6 competencies to form the basis of residency education [1,2]. In the proram requirements, the ACGME’s iagnostic Radiology Residency Reiew Committee states that residents ust “participate in identifying sysem errors and implementing potenial systems solutions” and be trained to analyze systemically the roblems, develop solutions, impleent solutions, and evaluate the efectiveness of the intervention” [3]. hus, residents need to be conductng and participating in quality imrovement projects as part of their esidencies. Engaging residents in a epartmental performance improveent initiative can provide them ith valuable experience in physician eadership, and the department gets a aluable asset in tackling problems. he real trick is incorporating these CGME requirements into an aleady overregulated and compressed esidency without it being the straw hat breaks the resident’s back [4]. The first step is to view this reuirement as a meaningful way to enich the residency program. On anther level and in a study of medical tudent education, schools that inorporated practice management raining into their programs found hat students were significantly more atisfied with their education than chools that did not [5]. Following re suggestions for incorporating a erformance improvement curricuum into your radiology residency rogram. Consider Quality Improvement as an “Antirotation”

Solitary lytic lesion of the skull.

Thyroid carcinoma metastatic to the calvaria may result in a lytic, well-circumscribed lesion the appearance of which necessitates differential consideration of lytic lesions of the skull. The merits of angiography in the study of such lesions are noted. Even in young persons, the possibility of metastasis presenting as a solitary lytic defect in the skull must be kept in mind.

Editor's Page: RadioGraphics' Progress in 2009 and Plans for 2010

RadioGraphics has had a very successful 2009 and continues its mission of publishing quality continuing medical education (CME) in radiology for RSNA (Radiological Society of North America) members and radiologists worldwide. In 2009, the Journal published over 130 educational manuscripts (including those based on education exhibits and plenary sessions, as well as other solicited articles) in 2186 pages, with many offered for CME credit. An excellent monograph (the annual seventh “special issue”), entitled “Current and Future Abdominal MR Imaging,” was published in October 2009, guest-edited by Dr Judy Yee from the University of California San Francisco. Approximately 13 CME exercises are now available in each print and online issue of RadioGraphics, and about 60,000 Category 1 CME credits were awarded for RadioGraphics CME activities in the 2009 calendar year. The 2008 impact factor for the Journal rose to 3.095 in 2009 (compared with 2.540 in 2008), which ranks RadioGraphics second among the major U.S. imaging journals. A few continuing and new initiatives for RadioGraphics in 2009 are notable. RGXPress, the Journal’s online manuscript processing system, is more robust than in 2008. All manuscripts are submitted, reviewed, and revised electronically. The system is achieving its goals of reducing expenses and easy use by authors, reviewers, and staff. RadioGraphics Online has been enhanced in several aspects. Manuscripts for online-only articles are now submitted and reviewed through RGXPress, which allows efficient, uniform manuscript processing and tracking. More attention has been given to these articles in the print edition of the Journal through the concept of “expanded abstracts” (vs abbreviated 250 words-only abstracts). Beginning in January 2009, online-only articles are now featured in the print edition with a 500-word abstract, two key images, teaching points, and selected readings. The expanded abstracts draw attention to online-only articles for all readers. The RadioGraphics home page has been redesigned for easier use and greater functionality. Its new look is beautiful and promotes easier reading and search functions. Lastly, the Journal is proud to be participating in the important, new Global Outreach Radiology (GO RAD) virtual journal project sponsored by the International Society of Radiology (http://www.isradiology.org/gorad ). For the 2009 annual meeting of the RSNA, RadioGraphics staff, editorial board, and its subspecialty panels charged with evaluating the education exhibits for possible publication in the Journal implemented new procedures to help assure the Journal’s compliance with the requirements of the Accreditation Council for Continuing Medical Education (ACCME). In addition, the Journal has increased the emphasis on and dissemination of the needs assessment information submitted by our CME participants, to be used in the selection of material for publication in upcoming issues. I have compiled these needs assessment data into a short table for editorial board use and readers’ information (Table). The topics listed represent “hot topics” and perceived knowledge gaps in subjects that readers want to see emphasized in the Journal in the near future. This information will be synthesized at least twice a year, shared with the RadioGraphics editorial board, and published in the January issue of each new volume of the Journal. Authors of manuscripts and education exhibits