Aquino Michael,  Koberlein George

Final Pr. ID: Poster #: EDU-098

Access to timely and accurate interpretation of imaging studies is critical to ensure quality care. This has driven demand for 24/7 radiology coverage. Examples of coverage models and solutions to logistical and financial challenges of providing around-the-clock real-time radiology services can be helpful as more children's hospitals move toward meeting this demand. The purpose of this exhibit is to describe the practice model used to provide after-hours pediatric radiology coverage at Cincinnati Children's Hospital Medical Center. Read More

Authors:  Aquino Michael , Koberlein George

Keywords:  Quality, Emergency, Trauma

Clavijo Rebecca

Final Pr. ID: Poster #: EDU-09 (R)

It has become challenging for pediatric imaging centers to keep up with the various national requirements regarding quality of patient care and safety issued by the Joint Commission and others. The American College of Radiology’s Diagnostic Imaging Center of Excellence program provides an avenue for pediatric radiology departments to demonstrate their qualifications of personnel, policies and procedures, equipment specifications, quality assurance activities, patient safety, image quality and the quality of patient care. Read More

Authors:  Clavijo Rebecca

Keywords:  Quality

Shah Summit,  Mcgonagill Phillip,  Hu Houchon,  Sankaran Akila,  Krishnamurthy Rajesh,  Krishnamurthy Ramkumar

Final Pr. ID: Poster #: SCI-030

The likelihood of sedation for an MRI exam in a patient under 8 years is high. Disadvantages of sedation usage include direct complications, suspected long-term effects, and higher costs. Sedation reduction techniques include the use of an MRI simulator, accelerated MRI scans, abbreviated protocols, and swaddle and sleep techniques. We evaluated the clinical image quality and cost effectiveness associated with an MRI simulator training program. Read More

Authors:  Shah Summit , Mcgonagill Phillip , Hu Houchon , Sankaran Akila , Krishnamurthy Rajesh , Krishnamurthy Ramkumar

Keywords:  MRI Sedation, Quality Improvement, Cost

Iles Benjamin,  Samora Julie,  Singh Satbir,  Ruess Lynne

Final Pr. ID: Poster #: SCI-035

Treatment pathways for isolated distal radius fractures in children are evolving and becoming more tailored to specific fracture types, including different management plans for stable buckle fractures (BFs) versus unstable distal radius fractures (DRFs). We propose a measurement rule to aid differentiation of stable BFs from unstable DRFs in children.
Read More

Authors:  Iles Benjamin , Samora Julie , Singh Satbir , Ruess Lynne

Keywords:  Quality Improvement, Radiography, Children

Don Steven,  Macdougall Robert,  Gress Dustin,  Burleson Judy

Final Pr. ID: Paper #: 137

The American College of Radiology (ACR) Dose Index Registry (DIR) compares site or practice exposure indices among regional and national values. While the CT DIR was established in 2011, Digital Radiography (DR) is only in the pilot phase. This single-site, single-vendor experience will inform the pediatric radiology community of the establishment of the ACR DIR DR module. Read More

Authors:  Don Steven , Macdougall Robert , Gress Dustin , Burleson Judy

Keywords:  Registry, Digital Radiography, Quality

Ruess Lynne,  Samora Julie

Final Pr. ID: Poster #: SCI-026

To test radiographic diagnostic accuracy for distinguishing between stable distal radius buckle fractures (BF) from other distal radius fractures (DRF) after introducing a measurement guideline.
Background: Management of pediatric forearm fractures has become fracture specific, as treatment of the common stable BF is trending toward home management with a removable wrist splint while other potentially unstable, DRF require immobilization and orthopaedic follow-up. Diagnostic accuracy between BF and DRF is therefore imperative. We developed and suggested our radiologists use a measurement guideline to aid diagnosis with this general rule: an isolated distal radius fracture in a child > 7y is not likely to be a BF if the fracture-to-physis distance is < 1 cm. Read More

Authors:  Ruess Lynne , Samora Julie

Keywords:  Quality Improvement, fracture, radiography

Tung Eric,  Ayyala Rama,  Sams Cassandra,  Swenson David

Final Pr. ID: Paper #: 027

In an effort to improve communication of important radiology findings, we designed and deployed a unique comprehensive radiology report categorization (RADCAT) system that organizes results by acuity and need for radiology follow-up. The goal of our study is to outline and compare the distribution of RADCAT pediatric imaging reports from three different clinical settings. Read More

Authors:  Tung Eric , Ayyala Rama , Sams Cassandra , Swenson David

Keywords:  Quality, Reporting, Grading

Tabari Azadeh,  Li Xinhua,  Yang Kai,  Liu Bob,  Gee Michael,  Westra Sjirk

Final Pr. ID: Paper #: 138

Scanner console-provided volume CT Dose Index (CTDIvol) and Dose Length Product (DLP) are frequently added up inappropriately to obtain cumulative dose values in patients exposed to multiple multi-sequence CT exams, performed with varying z-axis coverage and often with longitudinal tube current modulation. We present the patient-size specific Dose Line Integral (DLI) as a new metric that allows this task to be performed in a more precise fashion across multiple scanner platforms Read More

Authors:  Tabari Azadeh , Li Xinhua , Yang Kai , Liu Bob , Gee Michael , Westra Sjirk

Keywords:  Radiation, CT, Quality

Goncalves Luis,  Lindblade Christopher,  Cornejo Patricia,  Patel Mittun,  Wishah Fidaa,  Bardo Dianna

Final Pr. ID: Paper #: 107

The purpose of this study is to report visualization rates for standard cardiac axial views by FCMR using a prospective ECG pseudogating method and compare visualization rates for acquisitions performed in 1.5 and 3T. Secondary aims include a comparison of image quality between 2 observers and between 1.5 and 3T. Specific absorption rates (SAR) are also compared. Read More

Authors:  Goncalves Luis , Lindblade Christopher , Cornejo Patricia , Patel Mittun , Wishah Fidaa , Bardo Dianna

Keywords:  fetal cardiac MRI, 3T, image quality

Krishnamurthy Ramkumar,  Shah Summit,  Wang Ling,  Krishnamurthy Rajesh

Final Pr. ID: Paper #: 175

To analyze regional disparities in imaging utilization over an 8-year period in one of the largest pediatric Accountable Care Organizations (ACO) in the US covering over 300,000 children. Read More

Authors:  Krishnamurthy Ramkumar , Shah Summit , Wang Ling , Krishnamurthy Rajesh

Keywords:  Disparities, Economics, Quality

Yen Christopher,  Bhakta Kavita,  Terzo Madison,  Guleria Saurabh,  Hussaini Shaheen,  Huynh Tommy

Final Pr. ID: Poster #: SCI-014

Non-contrast MRI with focused rapid-acquisition sequences can be used in place of CT for effective diagnosis of pediatric acute appendicitis (PAS). However, higher costs and limited resources are major considerations when considering its use. The goal of this study was to evaluate accuracy, utilization, and cost of MR compared to US and CT in the diagnosis of PAS. Read More

Authors:  Yen Christopher , Bhakta Kavita , Terzo Madison , Guleria Saurabh , Hussaini Shaheen , Huynh Tommy

Keywords:  magnetic resonance, billing, quality

Sousae Sean,  Simmons Curtis,  Bailey Smita,  Cutler Kayci,  Youssfi Mostafa,  Reynolds Kristine,  Oliver Clay,  Pfeifer Cory

Final Pr. ID: Poster #: SCI-006

Growth in our hospital has resulted in multiple new locations opening which has resulted in staffing by ultrasound technologists lesser experienced in appendicitis imaging. Likewise, our ordering providers have increased their push to reduce CT utilization. Our aim was to improve the appendix visualization frequency by 10% over 6 months to reduce exposure to ionizing radiation, reduce cost for families, lower risk to patients, reduce length of stay in the emergency department, and shorten the time to diagnosis. Read More

Authors:  Sousae Sean , Simmons Curtis , Bailey Smita , Cutler Kayci , Youssfi Mostafa , Reynolds Kristine , Oliver Clay , Pfeifer Cory

Keywords:  Appendicitis, Quality Improvement, Ultrasound

Larsen Ethan,  Miranda Schaeubinger Monica,  Won James,  Sze Raymond,  Anupindi Sudha

Final Pr. ID: Poster #: EDU-042

Demonstrate the breadth and value of integrating a human factors engineer into a pediatric radiology department. Read More

Authors:  Larsen Ethan , Miranda Schaeubinger Monica , Won James , Sze Raymond , Anupindi Sudha

Keywords:  Quality, Safety, Human Factors

Shah Summit,  Rusin Jerome,  Krishnamurthy Rajesh,  Adler Brent H.

Final Pr. ID: Poster #: SCI-052

RADPEER has been criticized for lack of clinical implications, yet few studies have compared RADPEER to alternative peer-review systems or correlated peer review scores with changes in patient management. We aimed to implement a pediatric subspecialty over-read program and compare RADPEER to a Clinical Outcomes Scale, which graded impact on patient outcomes. Read More

Authors:  Shah Summit , Rusin Jerome , Krishnamurthy Rajesh , Adler Brent H.

Keywords:  Quality, Safety, Neuroradiology

Le Judy

Final Pr. ID: Poster #: EDU-05 (R)

The goal of this study is to educate Radiographers on varies specialty surfaces that are often under critical care patients and how they affect image quality on portable x-rays. By understanding which items cause image artifacts, radiographers can reduce the amount of repeated images and thus, decrease dose to patients. Read More

Authors:  Le Judy

Keywords:  portable imaging, infant, image quality

Fitzpatrick Laura,  Allain Dominic,  Schmit Pierre

Final Pr. ID: Poster #: SCI-024

Accurate placement of lines and tubes is essential in pre-hospital emergent care of pediatric patients, to ensure that lifesaving measuring can be initiated in an effective and timely manner. Malpositioned pediatric tubes can lead to failed resuscitation efforts. The purpose of this study is to determine the prevalence of misplaced endotracheal tubes (ETT), nasogastric tubes (NGT) and intraosseous trocars (IOT) in the pediatric acute care setting using post-mortem imaging. Read More

Authors:  Fitzpatrick Laura , Allain Dominic , Schmit Pierre

Keywords:  Emergency, Radiology, Quality

Tan Fei,  Zapala Matthew,  Durand Rachelle,  Chan Marilynn,  Larson Peder

Final Pr. ID: Poster #: SCI-035

MRI is not routinely used in clinical practice for lung imaging because of the low proton density and respiratory motion artifact. However, the ultrashort echo time (UTE) MRI technique can increase the signal in the lung. Image reconstruction techniques, such as iterative motion compensated (iMoCo) reconstruction, have improved respiratory motion management for free-breathing lung MRI scans. With the advantage of no ionizing radiation, MRI can benefit patients with immunodeficiency who often require repeat imaging, patients with heightened radiation sensitivity, and/or pediatric patients. In this abstract, we aim to evaluate the imaging quality of UTE lung MRI in the pediatric population. Read More

Authors:  Tan Fei , Zapala Matthew , Durand Rachelle , Chan Marilynn , Larson Peder

Keywords:  MRI, Image Quality, Lung

Mceniery Jane

Final Pr. ID: Poster #: EDU-027

Trampoline-related injuries in children are a common cause for presentation to the Emergency Department, and their incidence is increasing. Injuries to the lower limb are the most common. Transverse fractures of the proximal tibial metaphysis are a well-described classic fracture. These fractures may be subtle, only diagnosed at the time of follow up x rays. When reviewed at Radiology Quality Assurance meetings, these missed fractures were perceptible on the original imaging. We sought to examine the characteristics of fractures that were missed, and elucidate measures that could improve diagnostic accuracy. Read More

Authors:  Mceniery Jane

Keywords:  Trauma, Trampoline, Fracture, Quality Assurance, Emergency

Harris Chris

Final Pr. ID: Poster #: SCI-001 (R)

Background: Brain MRI has become an integral tool in the diagnosis and management of neonates with possible brain injury. In a large quaternary care neonatal intensive care unit (NICU), MRIs are routinely performed for the identification of white matter lesions in preterm infants, prognostication in hypoxic ischemic encephalopathy, peri-operative evaluation of patients with meningomyeloceles and hydrocephalus among other indications. Patients are often sedated in order to obtain high quality images, but sedation comes with complications. As these studies become an integral part of our practice in the NICU, we have identified a need to minimize the use of sedation to obtain clinically acceptable neonatal brain MRIs. Read More

Authors:  Harris Chris

Keywords:  Quality Improvements, Reduce Sedation, MRI brains

Shah Summit,  Krishnamurthy Ramkumar,  Kelleher Sean,  Krishnamurthy Rajesh

Final Pr. ID: Poster #: SCI-029

Two major insurance companies have recently enacted policies requiring outpatient advanced imaging at free-standing imaging facilities for adults. Examining the potential clinical and economic implications of non-subspecialized interpretations in children is important. We evaluated the rate of major discrepancies and changes in management arising from second interpretations by a dedicated pediatric facility. Read More

Authors:  Shah Summit , Krishnamurthy Ramkumar , Kelleher Sean , Krishnamurthy Rajesh

Keywords:  Healthcare Policy, Reimbursement, Quality Improvement