Model training strategies are described for use in scenarios in which there are limited datasets available. Data-driven approaches have great potential to shape future practices in radiology. The most straightforward strategy to obtain clinically accurate models is to use large, well-curated and annotate...

Background: In many risk-stratification systems, the decision to biopsy thyroid nodules is determined by their sonographic features and size. Nevertheless, even small, low-suspicion nodules are often biopsied because it is assumed that larger malignant nodules are associated with poorer outcomes. The aim of this study was to quantify the effect of thyroid cancer tumor size on survival and risk of T4 stage, nodal disease, and distant metastases. Methods: The Surveillance, Epidemiology, and End Results (SEER) 18 database was queried to obtain tumor size, staging information, and survival data for cases of differentiated thyroid cancer (DTC) and non-differentiated thyroid cancer reported between 2004 and 2014. Observed probabilities of tumor extent at diagnosis, including regional nodal disease and distant metastases, as a function of size and tumor histology were estimated for thyroid cancers measuring between 1 mm and 150 mm. A multivariate Cox regression model was used to describe all-cause mortality as a function of patient and tumor characteristics, and the functional dependence of mortality on size was computed. Results: 112,128 patients were analyzed, with 67% having thyroid cancers ≥1 cm, and 29% ≥2.5 cm. For DTC tumors under 4 cm, the risk of local invasion, nodal metastases or distant metastases was low, and there was no size threshold associated with a sharp rise in adverse outcomes. For DTC tumors smaller than 4 cm, the probability of distant metastases was under 3%. Older age, male sex, non-DTC histology, T4 stage, and regional and distant metastatic disease increased the all-cause mortality rate. Tumor size did not increase the mortality rate above baseline until tumors were larger than 2.5 cm. Conclusion: Increasing tumor size does not affect survival until a threshold of 2.5 cm. Since the dimension of nodules on ultrasound has been shown to be larger than their size at gross pathology, these findings suggest that recommended size thresholds to biopsy low-suspicion thyroid nodules can be increased.

Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, by impeding MRI workflow, they may affect the finances of an imaging practice. This review article offers an overview of the various types of patient-related unanticipated events that occur in MRI, along with estimates of their frequency of occurrence as documented in the available literature. In addition, the financial implications of these events are discussed from a microeconomic perspective, primarily from the point of view of a radiology practice or hospital, although associated limitations and other economic viewpoints are also included. Efforts to minimize these unanticipated patient events can potentially improve not only patient satisfaction and comfort but also an imaging practice's operational efficiency and diagnostic capabilities.

Patients undergoing MRI may experience fear, claustrophobia, or other anxiety manifestations due to the typically lengthy, spatially constrictive, and noisy MRI acquisition process and in some cases are not able to tolerate completion of the study. This article discusses several patient-centered aspects of radiology practice that emphasize interpersonal interactions. Patient education and prescan communication represent 1 way to increase patients’ awareness of what to expect during MRI and therefore mitigate anticipatory anxiety. Some patient interaction strategies to promote relaxation or calming effects are also discussed. Staff teamwork and staff training in communication and interpersonal skills are also described, along with literature evidence of effectiveness with respect to patient satisfaction and productivity endpoints. Attention to how radiologists, nurses, technologists, and other members of the radiology team interact with patients before or during the MRI scan could improve patients’ motivation and ability to cooperate with the MRI scanning process as well as their subjective perceptions of the quality of their care. The topics discussed in this article are relevant not only to MRI operations but also to other clinical settings in which patient anxiety or motion represent impediments to optimal workflow.

Background and Purpose: The existence of functional K_v7 channels in thalamocortical (TC) relay neurons and the effects of the K⁺‐current termed M‐current (I_M) on thalamic signal processing have long been debated. Immunocytochemical evidence suggests their presence in this brain region. Therefore, we aimed to verify their existence, pharmacological properties and function in regulating activity in neurons of the ventrobasal thalamus (VB).Experimental Approach: Characterization of K_v7 channels was performed by combining in vitro, in vivo and in silico techniques with a pharmacological approach. Retigabine (30 μM) and XE991 (20 μM), a specific K_v7 channel enhancer and blocker, respectively, were applied in acute brain slices during electrophysiological recordings. The effects of intrathalamic injection of retigabine (3 mM, 300 nL) and/or XE991 (2 mM, 300 nL) were investigated in freely moving animals during hot‐plate tests by recording behaviour and neuronal activity.Key Results: K_v7.2 and K_v7.3 subunits were found to be abundantly expressed in TC neurons of mouse VB. A slow K⁺‐current with properties of I_M was activated by retigabine and inhibited by XE991. K_v7 channel activation evoked membrane hyperpolarization, a reduction in tonic action potential firing, and increased burst firing in vitro and in computational models. Single‐unit recordings and pharmacological intervention demonstrated a specific burst‐firing increase upon I_M activation in vivo. A K_v7 channel‐mediated increase in pain threshold was associated with fewer VB units responding to noxious stimuli, and increased burst firing in responsive neurons.Conclusions and Implications: K_v7 channel enhancement alters somatosensory activity and may reflect an anti‐nociceptive mechanism during acute pain processing.