Medical 3D printing is an ever-changing method of medical advancements, including a growing space for developing custom training tools (phantoms). Phantoms have enhanced pediatric medicine, offering improved training, planning, and educational tools tailored to specific patients. This abstract evaluated and explored the application of radio-programmable 3D printing material, RadioMatrix, under both X-ray and CT scans. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Naqvi Iman, Polk Elizabeth, Velazquez Guzman Angel, Silvestro Elizabeth

Keywords: 3D Printing, Phantom, Education

Magnetic Resonance (MR) safety education is essential to protect patients and staff from hazards, especially by preventing ferrous items from entering Zones 3 (control and changing areas) and 4 (magnet room). To address this, our MR Safety Committee focused on improving safety signage. A Radiology Human Factors Engineer (HFE) observed staff interactions within MR zones, focusing on adherence to entrance screening protocols. The observations revealed that non-MR medical professionals, less familiar with safety protocols, could unintentionally enter with hazardous items, and that staff may check on their first entry, but forget to check again on subsequent re-entry. Therefore, new signage needed to be eye-catching and memorable. In 2023, the committee introduced "Tess" (short for Tesla), a life-size cardboard cutout of an MR Safety mascot. Tess, a cartoon MR technologist in scrubs, highlights common ferrous items staff should check for, head-to-toe. She holds a sign reading, “You are about to enter Zone 3: Are you CLEAR?” followed by the item list and CLEAR acronym’s safety instructions. The concept, acronym, and design were developed by the HFE with input from the MR team and digitally rendered by a medical illustrator using Adobe Illustrator 2023. The design adheres to the hospital’s branding and was printed by an external vendor. Tess was placed at the Zone 3 entrance in three different MR areas. After positive feedback from technologists and committee members, the Facilities team expanded Tess’s presence by adding her to large vinyl signs on Zone 4 doors where she points to frequently overlooked ferrous items. During the 2024 MR Safety Week, Tess was central to hands-on education. Radiology interns 3D-printed the ferrous items Tess highlights, allowing staff to physically engage with the mascot and remove the items. This interactive approach drew participants in to spread awareness of MR safety practices. Tess was also integrated into the hospital’s online MR safety training module, developed by the Digital Learning team. In this module, users drag items from Tess’s pockets, hair, and hands into a designated locker, reinforcing the habit of checking for those ferrous objects. We are monitoring Tess’s impact on compliance and safety and believe she could be adapted for use in other high-risk areas, such as operating rooms and interventional radiology suites, where strict safety protocols are crucial. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Bennett Brittany, Larsen Ethan, Prodigios Joice, Silvestro Elizabeth

Keywords: Quality And Safety, Magnetic Resonance Imaging

The rapid growth of contrast-enhanced ultrasound research and applications presents the need for cooresponding educational tools and training methods. Hands-on education is an ideal mechanism for learning image techniques, sparking active engagement and curiosity to learn more. Custom pediatric phantoms for ceVUS allow for specific education goals in an engaging and translatable fashion and allow the learner to practice the technique prior to engaging in patient care. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Silvestro Elizabeth, Morgan Trudy, Bennett Brittany, Brennan Elizabeth, Back Susan

Keywords: Contrast Enhanced Ultrasound, 3D Printing, Simulation

Risk stratification of the most common pediatric primary liver malignancies, hepatoblastoma and hepatocellular carcinoma, is dependent on imaging criteria that ultimately inform work-up and clinical management. The Pediatric Liver Reporting and Data System (LI-RADS) Working Group recommends use of the PRETEXT (PRE-Treatment EXTent of tumor) staging system, which is utilized in the ongoing Pediatric International Tumor Trial (1). PRETEXT staging is first performed by dividing the liver into four sections. Based on how many contiguous sections are free of tumor, a group is assigned from I-IV. Second, annotations factors are assessed depending on the presence of vessel involvement, rupture, multifocality, extrahepatic spread, or metastatic disease, which portend higher risk (2). Understanding and applying the PRETEXT system should be a core competency for all current and aspiring pediatric radiologists. The PRETEXT system has some barriers to learning, namely in discerning the anatomical liver sections from the functional ‘Couinaud’ segments and accurately determining vessel involvement. We saw the opportunity to combine our diagnostic pediatric radiologic experience/expertise with the application of 3D printing technology. Through the segmentation of post-contrast T1 fat-saturated MRI images, we were able to build 3D models of different PRETEXT stage disease. The aim of this educational exhibit is to provide pediatric radiologists with an alternative learning tool to appreciate the PRETEXT system and its application. It will combine the proficiency of a 3D pediatric additive manufacturing lab and diagnostic pediatric radiologists with expertise in oncologic imaging and fellowship teaching. Models and their representative 3D renderings will demonstrate the differences between PRETEXT stages, with and without the presence of various annotation factors. 1. Schooler GR, Squires JH, Alazraki A, Chavhan GB, Chernyak V, Davis JT, et al. Pediatric Hepatoblastoma, Hepatocellular Carcinoma, and Other Hepatic Neoplasms: Consensus Imaging Recommendations from American College of Radiology Pediatric Liver Reporting and Data System (LI-RADS) Working Group. Radiology. 2020 Sep;296(3):493–7. 2. Towbin AJ, Meyers RL, Woodley H, Miyazaki O, Weldon CB, Morland B, et al. 2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT). Pediatr Radiol. 2018 Apr;48(4):536–54. Read More

Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023

Authors: Schoeman Sean, Venkatakrishna Shyam Sunder, Silvestro Elizabeth, Cajigas-loyola Stephanie, Acord Michael

Keywords: PRETEXT Staging, 3D Printing, MRI

Reading Room Coordinators (RRCs) are crucial for radiology department operations. Studies have shown the positive impact of RRCs in improving workflow efficiency for radiologists. Despite their critical role in facilitating communication and minimizing disruptions to radiologists’, RRCs often experience significant workflow interruptions, primarily due to constant phone calls and multitasking demands. Our practice’s RRCs receive ~7700 inbound calls per week in addition to all outbound calls, emails, and legal requests. These interruptions may impact radiologists, radiology operations, other hospital departments, and patients and families downstream. We examined the barriers affecting RRC workflow using the SEIPS (Systems Engineering Initiative for Patient Safety) framework from human factors (HF). We implemented interventions to overcome those barriers to increase efficiency, reduce interruptions, and improve the work environment. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Parmar Sweta, Liu Ray, Larsen Ethan, Macon Reyna, Nigro Alessandria, Silvestro Elizabeth, Anupindi Sudha

Keywords: Workload, Wellness, Improvement

Teaching fluoroscopy skills remains an ongoing challenge in pediatric radiology education. Radiologists must be competent to perform a wide range of fluoroscopy procedures and are often required to teach these clinical skills to their peers, junior staff, and students. Teaching procedural skills through frameworks, observation, and feedback, with opportunities for repeated practice, assists in the learner’s acquisition and retention of skills. Fluoroscopy presents patient safety and ethical challenges as “practicing” this skill on patients requires ionizing radiation exposure and often invasive procedures. Through this educational exhibit, we describe a proposed program to improve skill performance, determine competency, and provide feedback. To improve voiding cystourethrogram (VCUG) training two patient models were created for bladder catheterization with different grades of vesicoureteral reflux using 3D printing and silicon rubber. Additional educational materials, including videos and graphical representations, were created to better help the learner understand the steps of the VCUG protocol. A three-component curriculum included 1) Knowledge (indications, contraindications, complications); 2) Communication (with patient and family, with fluoroscopy team); and 3) Performance of the skill (preparation before commencing, steps and dexterity, immediate aftercare of the patient). We modeled our evaluation of the learner from Peyton’s four-step approach to skills teaching (Demonstration, Deconstruction, Formulation, and Performance) to teach the physical performance of the fluoroscopy procedure. Feedback was provided to the learners using the Pendleton Feedback Model. Finally, competency was assessed using the Framework for clinical assessment developed by Miller. This educational exhibit aims to provide radiologists in training with an alternative learning curriculum to better understand and evaluate the steps of the VCUG and its performance on patients in a simulated setting before being performed on patients. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Veselis Clinton, Venkatakrishna Shyam Sunder, Silvestro Elizabeth, Bennett Brittany, Srinivasan Abhay, Acord Michael, Sze Raymond, Reid Janet, Anupindi Sudha

Keywords: Voiding cystourethrogram, VCUG, Fluoroscopy