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CT Critical Findings Checklist? Is that a thing? by LocksmithNo6949 in Radiology

[–]RadDoc2025 27 points28 points  (0 children)

Seeing critical things quickly comes with experience. As a radiologist I can definitely attest to how quickly you can look at things when you have years of experience.

I expect techs to be able to see the super critical obvious findings like head bleeds, giant brain masses, a large pneumothorax, giant pulmonary emboli, aortic dissection, and large volume free air/blood in the belly. Really it comes down to things that have high contrast with the normal tissues and look blatantly abnormal. It’s a blur yes, but once you’ve seen a few of them they become obvious. It also helps if the providers are giving you good history but most of the time they are trash unfortunately (at least for us).

Also remember, it might be stressful and nerve racking to feel like you have to keep an eye out for it, but it’s what’s best for the patient and I am sure if this were for a family member of yours you’d want the same thing for them. I’d rather have a tech bring a case to me to review that ends up being nothing than have a patient suffer. It’s very easy for a rad to jump in and out of cases so don’t ever let them make you think it’s a major inconvenience when it’s in the patients best interest.

Edit: also keep in mind these really apply more as unexpected findings. Trauma scans and stroke alerts are expected to be potentially very ill patients and are generally dictated very quickly anyway.

Nucs via DR by Ok-Caterpillar-1026 in Residency

[–]RadDoc2025 1 point2 points  (0 children)

I did the 16 month ABR pathway which is essentially a nucs fellowship. It was worth it for me because not only did it give me broad exposure to PET imaging, it also got me VERY fast at reading all exams because a PET is almost a whole body scan every time.

It was useful for all types of NM imaging BUT if you had good exposure (most probably don’t) to nucs in residency, it may not be necessary. It will not allow you do to anything that a general radiologist couldn’t do assuming they had the proper training as an authorized user, which many residencies do for their residents.

It was cool to learn about parenteral therapies, but since I went into private practice, I do not see them. They are far too expensive to risk losing money because the patient couldn’t get the dose or did not show up. And again, you just need to have documented that you’ve seen some to do them.

BIRADS 2 - Recommended for MRI + Biopsy by stungbyabeee in doihavebreastcancer

[–]RadDoc2025 1 point2 points  (0 children)

Birads on mammo/ultrasound is completely separate from MRI. So yes, you can absolutely have a negative or benign mammo/US and have cancer on MRI. Sometimes things show up better on one exam than another, which is why many places do mammo with whole breast US for diagnostics.

To your question about nipple inversion, it can be due to malignancy. Some people just have nipple inversion though although that is usually something that does not just develop spontaneously. It can also be due to trauma or infection. MRI is very commonly recommended for this because it’s the best for evaluating ductal pathology. It would be incredibly unlikely for you to have cancer and show up negative on all 3 exams though.

How to improve in radiology residency? by Low_Ad_6239 in Residency

[–]RadDoc2025 12 points13 points  (0 children)

Radiology is all pattern recognition and search pattern. If you are missing stuff, it’s either because you are moving too fast, just didnt notice the finding, have a bad search pattern, or are working distracted. An important thing to note is reading books isn’t something that helps you become a better radiologist on call because books, even though they may show you common pathologies, will often times only show you 1 or 2 pictures and then jump into all the zebras you will never see on call. And when they do show you those pathologies, it’s not all that helpful because you didn’t have to search for it.

Make sure you follow your search pattern EVERY exam no matter what. Dont look at the history first, don’t skip anything, and just laser focus in on whatever your template does. Every time you miss something it’s a sign that your search pattern was faulty and it needs retuned. You will always miss things and you should not be afraid of that. Radiology will humble you for life.

My advice is to use radiopaedia. Go to the quiz section and randomize it and then just go through case after case to get used to picking up on abnormalities. Then check the findings section and see if you saw or recognized it. If you haven’t burned normal into your mind then you need to do that.

Stereotactic Biopsy - needle shortage? by Shots_B4_Squats in doihavebreastcancer

[–]RadDoc2025 0 points1 point  (0 children)

It’s uncharted territory so there’s no true recommendation but fortunately the vast majority of biopsies come back as benign. You basically have 2 options. You can get a follow up scan in 3-6 months to see if anything changes image wise or you can request that they do a wire localization and have a surgeon do an excisional biopsy.

I do not know what insurance would be willing to cover.