Sunday, November 26, 2017


Exciting to be back in windy city to attend 103th RSNA.
Excellent line up at the Expo as usual. There is a lot more AI-driven imaging companies this year. AI/machine learning a huge presence and theme throughout both education and business aspects of this year's meeting.

Back to diagnostic radiology: I attended the Thyroid imaging session today and it was outstanding. Speakers: Jill Langer, Kathryn Robinson and Sheila Sheh.
-ACR TI-RADS in here! It's easy to use and the descriptors will be able to categorize all thyroid nodules, unlike American Thyroid Association.
-Besthesda classification is great for risk stratifying indeterminate nodules (FLUS/AUS, follicular adenoma, etc)
-Molecular risk stratification is great for FLUS/AUS indeterminate nodules and has 95% NPV. If molecular signature is benign, patients do not need surgery! Molecular risk stratification has decreased operation rates from 80% to <10% for indeterminate nodules!
-Affirma (Veracyte) and ThyroSeq2 have high NPV (>90%) and reasonable PPV (mid 70%). But ThyroSequence 3 (newly released) is suppose to have even higher PPV!
-Suspicious thyroid nodule on US needs further follow up even if molecular signature benign!
-Most common place for LN recurrence after surgery is central neck (level 6)
-Use standardized reporting for LN and ask techs to standardized image acquisition to add value to report for our referring providers.
-American Thyroid Association becoming more conservative about thyroid nodule management and supporting hemi over total thyrodectomies for small nodules.
-Current efforts underway to get unified recommendations from ATA, ACR and possibly SRU.

A few additional notes:
-RSNA2017 app is great! It's super user friendly and very good interface. You can search keywords for people, institutions, topics. Outstanding job with the app #RSNA2017!
-AGFA dinner is Monday night (for all you Agfa customers/clients).
-UCLA alumni dinner is Tuesday night at the Omni Hotel
-RadXX gathering Tuesday night to support women advocacy.

Looking forward to tomorrow!  Too many great sessions to choose from!

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