Zaki-Metias K, Hurrell C, Miller E
… +2 more, Volders D, Chawla T
Can Assoc Radiol J
· 2026 May · PMID 40890934
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PURPOSE: This study aimed to assess the experiences and challenges faced by Canadian radiologists participating in Multidisciplinary Team rounds (MDT), with a focus on demographics, meeting characteristics, preparation p...PURPOSE: This study aimed to assess the experiences and challenges faced by Canadian radiologists participating in Multidisciplinary Team rounds (MDT), with a focus on demographics, meeting characteristics, preparation processes, and perceptions of workload and compensation. METHODS: The Canadian Association of Radiologists constituted a working group which developed a 35-question survey that was distributed to 1958 radiologists and radiology trainees across Canada. The survey garnered 129 complete responses, for a response rate of 6.6%. RESULTS: Respondents predominantly practiced in academic settings (65.9%) and had subspecialty training (96.1%). The majority reported that MDT rounds lasted 30 to 60 minutes and discussed 6 to 10 cases. Most radiologists (62.8%) were the sole presenters of imaging. Preparation time was often limited, with only 6.2% having dedicated time for preparation. 59.8% of respondents reported receiving additions to caseloads within the 24-hour period prior to the meetings. While 93.8% valued the opportunity for interaction with colleagues, 93.8% felt inadequately compensated for their efforts by their practices, while 92.3% felt inadequately compensated by their province. CONCLUSIONS: While most radiologists indicated adequate time for discussion and meaningful clinical engagement during rounds, many highlighted repeated challenges such as last-minute case additions, lack of protected preparation time, and technological barriers. Systemic barriers also play a role and include lack of provincial remuneration and workforce issues which in turn impact individual workload pressures.
Ghasempourabadi M, O'Neill H, Murray N
… +1 more, Harris A
Can Assoc Radiol J
· 2026 Feb · PMID 40876812
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Dual-energy computed tomography has become a pivotal tool in abdominal imaging, particularly for pancreatic pathologies such as pancreatic ductal adenocarcinoma, trauma assessment, and acute pancreatitis. Its ability to...Dual-energy computed tomography has become a pivotal tool in abdominal imaging, particularly for pancreatic pathologies such as pancreatic ductal adenocarcinoma, trauma assessment, and acute pancreatitis. Its ability to provide enhanced contrast resolution, reduce artifacts, and optimize radiation dose makes it invaluable in both acute and non-acute clinical settings. This narrative review summarizes the technological advancements and clinical applications of dual-energy computed tomography in pancreatic imaging. A comprehensive review of 21 peer-reviewed studies published between 2013 and 2024 was conducted to evaluate the role of dual-energy computed tomography in all pancreatic imaging indications, including tumor detection, pancreatitis assessment, trauma evaluation, and radiation dose optimization. The analysis included retrospective and prospective studies retrieved from multiple databases, including PubMed, Scopus, and Google Scholar. The findings highlight the technology's capacity to improve diagnostic accuracy, reduce image artifacts, and lower radiation exposure through techniques such as virtual monoenergetic imaging and iodine quantification. Comparisons with conventional computed tomography focused on diagnostic performance metrics such as contrast-to-noise ratio, and signal-to-noise ratio. Additionally, this narrative review underscores the clinical relevance of dual-energy computed tomography in evaluating non-traumatic acute abdominal conditions, especially among elderly patients.
Thompson BT, Kamali K, Abdolell M
… +2 more, Rivers-Bowerman M, Costa AF
Can Assoc Radiol J
· 2026 May · PMID 40853050
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INTRODUCTION: This study aimed to determine the positive predictive value (PPV) of magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) machine fusion prostate biopsies, and to identify factors associated with a...INTRODUCTION: This study aimed to determine the positive predictive value (PPV) of magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) machine fusion prostate biopsies, and to identify factors associated with a positive biopsy. METHODS: With ethics approval, we retrospectively evaluated all MRI-TRUS machine fusion prostate biopsies at our institution from September 2022 to April 2025. True positive clinically significant prostate cancers (csPCa) were defined as Gleason ≥7. PPVs were calculated overall and for PI-RADS 3, 4 and 5 categories. A generalized linear mixed model (GLMM) was created evaluating the following factors as fixed effects: PI-RADS category; prostate-specific antigen (PSA) density (<0.10, 0.10-0.15, ≥0.15 ng/mL); lesion size (<7, 7-15, ≥15 mm); lesion location (peripheral vs transition zone); ultrasound correlate (present/absent); prostate size (<60 vs ≥60 mL); interval from MRI to biopsy (<6 months or not); and biopsy operator (2 radiologists). Referring urologist (n = 19) and reporting radiologist (n = 8) were included as random effects. RESULTS: 372 patients (mean age, 67 ± 7 years) with 529 lesions underwent biopsy. The overall PPV was 314/529 (59.4%). For PI-RADS 3 to 5, PPVs were 32/72 (44.4%), 123/243 (50.6%), and 159/214 (74.3%), respectively. In GLMM analysis, PI-RADS 5 versus 3 (OR 3.6, 95% CI, 1.7-7.4), PSA density ≥0.15 ng/mL (OR 2.2, 95% CI, 1.2-3.8), and presence of an ultrasound correlate (OR 2.7, 95% CI, 1.7-4.2) were associated with true positive biopsies. Small lesion size <7 mm was associated with a false positive biopsy (OR 0.4, 95% CI, 0.2-0.8). CONCLUSION: The yield of fusion prostate biopsies at our institution is high. PI-RADS 5, PSA density ≥0.15 ng/mL, and an ultrasound correlate at biopsy were associated with csPCa, whereas sub-7 mm lesions were negatively associated with csPCa.
Smith RL, Linehan V, Burrell S
… +1 more, Macdonald IR
Can Assoc Radiol J
· 2026 May · PMID 40852954
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PURPOSE: To correlate parathyroid scintigraphy results with patient biochemistry, surgery, and pathology to inform appropriateness criteria and assess biochemical metrics in the imaging workup of hyperparathyroidism. MET...PURPOSE: To correlate parathyroid scintigraphy results with patient biochemistry, surgery, and pathology to inform appropriateness criteria and assess biochemical metrics in the imaging workup of hyperparathyroidism. METHODS: This retrospective study included 421 patients who underwent parathyroid scintigraphy. Patients were grouped based on primary versus secondary hyperparathyroidism, and clinical profiles were reviewed for scan result, blood work, surgical results, and pathology. Performance metrics of scintigraphy were analyzed. Demographics, bloodwork, and location were compared between positive and negative scans. Predictors of positive scans were identified by multivariate logistic regression analysis. The performance of biochemistry to predict scan results was evaluated by ROC analyses. RESULTS: Positive tests-occurring in 52% of patients-were associated with higher parathyroid hormone (PTH) and corrected calcium. However, PTH was only predictive of a positive test in patients with secondary hyperparathyroidism. On multivariate analysis, male sex, corrected calcium, and younger age were predictors of a positive scan. Corrected calcium was the most predictive with an OR of 1.28 for every 0.1 mmol/L increase. Based on ROC analysis, corrected calcium had an AUC of 0.628 and a cutoff of 2.65 mmol/L maximized sensitivity (88%) and specificity (35%) for a positive test. CONCLUSION: In this large retrospective cohort, several biochemical metrics, including corrected calcium levels, were predictive of a positive scintigraphy study. Furthermore, biochemistry, including PTH levels, significantly differed between primary and secondary hyperparathyroidism suggesting that tailored biochemical metrics are required. This work sets a foundation for the development of a robust biochemical scoring system to optimize patient selection for parathyroid imaging.
Can Assoc Radiol J
· 2026 May · PMID 40810437
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Artificial intelligence (AI) and sustainability have been the subject of much research in the field of radiology throughout 2025. The future of the radiologist and our planet has been called into question. We have had to...Artificial intelligence (AI) and sustainability have been the subject of much research in the field of radiology throughout 2025. The future of the radiologist and our planet has been called into question. We have had to shift focus and evolve to embrace the progress AI can bring while limiting our environmental impact and maximising efficiency in the face of an ever-increasing workload. This year's Canadian Association of Radiologists Journal "Year in Review" revisits the 10 most powerful articles published by our journal in 2025, exploring what's next for AI, sustainability and system efficiency.
Wilson MP, Tang A, Low G
… +14 more, Zhang LX, Costa AF, Pang E, Chang S, Medellin A, Shaheen AA, Dana J, Millo N, Kielar A, Swain M, Leung V, Fung D, Hurrell C, Fung C
Can Assoc Radiol J
· 2026 Feb · PMID 40765159
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The Canadian Association of Radiologists (CAR) metabolic dysfunction-associated steatotic liver disease (MASLD) Working Group (WG) is a multidisciplinary working group composed of radiologists, hepatologists, and family...The Canadian Association of Radiologists (CAR) metabolic dysfunction-associated steatotic liver disease (MASLD) Working Group (WG) is a multidisciplinary working group composed of radiologists, hepatologists, and family physicians. In this 3-part series, we provide Delphi consensus-based guidance on clinical and imaging findings for patients with known or suspected MASLD (formerly termed non-alcoholic fatty liver disease or NAFLD). Part 1 focuses on the detection and grading of hepatic steatosis on imaging; Part 2 on risk-stratification of patients with MASLD, including a patient pathway that incorporates serological and imaging investigations; and Part 3 on the implementation of practice recommendations for quality assurance using shear wave elastography (SWE) and magnetic resonance elastography (MRE) for disease staging. In the first part of these guidelines, we provide 17 guidance statements for detection, grading, and surveillance of hepatic steatosis using ultrasound (US), CT, or MRI. In addition to conventional B-mode US, we review current evidence on semi-quantitative and quantitative US techniques and provide guidance for appropriate indications and recommended technique.
Wilson MP, Low G, Medellin A
… +15 more, Chang SD, Pang E, Whitaker T, Costa AF, Tang A, Dana J, Millo N, Kielar A, Zhang LX, Shaheen AA, Swain M, Leung V, Fung D, Hurrell C, Fung C
Can Assoc Radiol J
· 2026 Feb · PMID 40765155
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The Canadian Association of Radiologists (CAR) metabolic dysfunction-associated steatotic liver disease (MASLD) Working Group (WG) is a multidisciplinary working group composed of radiologists, hepatologists, and family...The Canadian Association of Radiologists (CAR) metabolic dysfunction-associated steatotic liver disease (MASLD) Working Group (WG) is a multidisciplinary working group composed of radiologists, hepatologists, and family physicians. In this 3-part series, we provide Delphi consensus-based guidance on clinical and imaging findings for patients with known or suspected MASLD (formerly termed nonalcoholic fatty liver disease or NAFLD). Part 1 focuses on the detection and grading of hepatic steatosis on imaging; Part 2 on risk stratification of patients with MASLD, including a patient pathway that applies blood-based and imaging-based investigations; and Part 3 on the implementation of practice recommendations for quality assurance using shear wave elastography (SWE) and magnetic resonance elastography (MRE) for disease staging. In the third part of these guidelines, the WG provides 18 recommendations for standardized implementation, remuneration, and quality assurance for SWE and MRE programs. Structured reporting templates for standardized SWE and MRE are provided. Introductory training presentations for technologists and radiologists are also provided. The goal of these guidelines is to enable standardized image-based screening and risk stratification of patients with MASLD across Canada.
Wilson MP, Low G, Shaheen AA
… +15 more, Costa AF, Tang A, Pang E, Chang S, Medellin A, Dana J, Millo N, Kielar A, Zhang LX, Whitaker T, Swain M, Leung V, Fung D, Hurrell C, Fung C
Can Assoc Radiol J
· 2026 Feb · PMID 40765154
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Publisher ↗
The Canadian Association of Radiologists (CAR) metabolic dysfunction-associated steatotic liver disease (MASLD) Working Group (WG) is a multidisciplinary working group composed of radiologists, hepatologists, and family...The Canadian Association of Radiologists (CAR) metabolic dysfunction-associated steatotic liver disease (MASLD) Working Group (WG) is a multidisciplinary working group composed of radiologists, hepatologists, and family physicians. In this 3-part series, we provide Delphi consensus-based guidance on clinical and imaging findings for patients with known or suspected MASLD (formerly termed nonalcoholic fatty liver disease or NAFLD). Part 1 focuses on the detection and grading of hepatic steatosis on imaging; Part 2 on risk-stratification of patients with MASLD, including a patient pathway using serological and imaging investigations; and Part 3 on the implementation of practice recommendations for quality assurance using shear wave elastography (SWE) and magnetic resonance elastography (MRE) programs. In Part 2 of these guidelines, the WG provides 14 recommendations for risk stratifying MASLD patients into low and high risk for advanced hepatic fibrosis ( ≥ 3) using a combination of serological and imaging investigations. Population screening and risk stratification of MASLD patients using a clinical and serological investigation (FIB-4) followed by imaging pathway is recommended. Clinical, technical, and grading recommendations for point shear wave elastography (pSWE), 2-dimensional SWE (2D-SWE), and MRE are discussed.
Sussman MS, Cui L, Tan SBM
… +4 more, Prasla S, Wah-Kahn T, Nickel D, Jhaveri KS
Can Assoc Radiol J
· 2026 Feb · PMID 40755270
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PURPOSE: In pelvic MRI, Turbo Spin Echo (TSE) pulse sequences are used for T2-weighted imaging. However, its lengthy acquisition time increases the potential for artifacts. Deep learning (DL) reconstruction achieves redu...PURPOSE: In pelvic MRI, Turbo Spin Echo (TSE) pulse sequences are used for T2-weighted imaging. However, its lengthy acquisition time increases the potential for artifacts. Deep learning (DL) reconstruction achieves reduced scan times without the degradation in image quality associated with other accelerated techniques. Unfortunately, a comprehensive assessment of DL-reconstruction in pelvic MRI has not been performed. The objective of this prospective study was to compare the performance of DL-TSE and conventional TSE pulse sequences in a broad spectrum of pelvic MRI indications. METHODS: Fifty-five subjects (33 females and 22 males) were scanned at 3 T using DL-TSE and conventional TSE sequences in axial and/or oblique acquisition planes. Two radiologists independently assessed image quality in 6 categories: edge definition, vessel margin sharpness, T2 Contrast Dynamic Range, artifacts, overall image quality, and lesion features. The contrast ratio was calculated for quantitative assessment. A two-tailed sign test was used for assessment. RESULTS: The 2 readers found DL-TSE to deliver equal or superior image quality than conventional TSE in most cases. There were only 3 instances out of 24 where conventional TSE was scored as providing better image quality. Readers agreed on DL-TSE superiority/inferiority/equivalence in 67% of categories in the axial plane and 75% in the oblique plane. DL-TSE also demonstrated a better contrast ratio in 75% of cases. DL-TSE reduced scan time by approximately 50%. CONCLUSION: DL-accelerated TSE sequences generally provide equal or better image quality in pelvic MRI than standard TSE with significantly reduced acquisition times.
Chin S, Langan A, Walker R
… +3 more, Harris A, Soulez G, Kielar A
Can Assoc Radiol J
· 2026 Feb · PMID 40754865
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Waiting times for medical imaging examinations in Canada are growing as the demand for these tests exceeds current capacity. This document summarizes strategies that may be employed to increase medical imaging patient th...Waiting times for medical imaging examinations in Canada are growing as the demand for these tests exceeds current capacity. This document summarizes strategies that may be employed to increase medical imaging patient throughput in an environment of limited resources. This document also advocates for provincial measures to optimize use of resources and national policies that support sustainable radiology services to meet growing demand now and in the future.
Nair JR, Abdulla S, Bharatha A
… +2 more, Joshi M, Mathur S
Can Assoc Radiol J
· 2026 Feb · PMID 40632580
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PURPOSE: The precentral cortex normally demonstrates lower signal intensity compared to remainder of the neocortex on 2D fluid attenuated inversion recovery (FLAIR) images. Loss of this normal hypointensity bilaterally c...PURPOSE: The precentral cortex normally demonstrates lower signal intensity compared to remainder of the neocortex on 2D fluid attenuated inversion recovery (FLAIR) images. Loss of this normal hypointensity bilaterally can be seen in patients with adult hypoxic-ischemic brain injury (HIBI). We have named this the 'FLAIR motor' sign (FMS). The performance of this sign for detection of HIBI is evaluated in this case-control study. METHODS: MRI studies of 74 consecutive patients with clinical evidence of HIBI following cardiac arrest formed the 'case' group. Controls comprised of normal MRI studies of an equal number of age and gender matched patients. Two fellowship-trained neuro-radiologists reviewed the MRI studies in a blinded randomized fashion and recorded the presence or absence of 'FLAIR motor' sign. RESULTS: Average time from cardiac arrest to MRI was 7.12 days (range: 1-25 days). The average sensitivity and specificity of 'FLAIR motor' sign for HIBI was 86.49% and 100% respectively. The sign demonstrated excellent inter-reader agreement (kappa >0.8). CONCLUSION: The loss of the normal hypointensity in bilateral pre-central cortex on 2D-FLAIR images is a specific and reliable MRI sign of HIBI in the subacute phase following cardiac arrest in adults.
Can Assoc Radiol J
· 2026 Feb · PMID 40632579
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Radiomics is a mathematical approach to medical images to extract quantitative features generating a "radiomics signature." The radiomics workflow involves image acquisition and pre-processing, region of interest segment...Radiomics is a mathematical approach to medical images to extract quantitative features generating a "radiomics signature." The radiomics workflow involves image acquisition and pre-processing, region of interest segmentation, feature extraction, and then model training and validation. It has generated promising results, however, clinical implementation for early detection remains a challenge. Pancreatic ductal adenocarcinoma (PDAC), the most common pancreatic cancer, has a highly aggressive nature with an aggregated 5-year survival rate of only 13%. Early detection of PDAC provides timely surgical intervention, hoping for improved survival rates. Radiomics has been applied to the detection of PDAC; however, its sensitivity to variations in image acquisition parameters has posed significant challenges, limiting the development of robust and generalizable models. This review explores the current landscape of radiomics for the early detection of PDAC, highlighting key challenges within the radiomics workflow and barriers to its progression from a proof-of-concept into clinical practice.