Publications

PURPOSE: Imposter phenomenon refers to feelings of inadequacy due to inability to internalize evident success. While high achievers such as physicians have been known to exhibit imposter phenomenon, there is limited literature specific to radiologists. Our purpose was to (1) investigate imposter phenomenon in radiologists and assess correlation with burnout, and (2) pilot an intervention aimed at addressing imposter phenomenon through improvisational theater techniques.

METHODS: Part 1 - Clinical radiology faculty at a single large academic medical center completed an anonymous survey with questions related to demographics, burnout (derived from the validated Mini-Z assessment tool), and imposter phenomenon. Part 2 - A one-hour interactive workshop on imposter phenomenon was organized for the radiology department at the same institution. The workshop included the Clance Imposter Phenomenon Scale (CIPS). A post-workshop survey rating was also performed.

RESULTS: Part 1 - Of 30 clinical radiology faculty who participated in the survey, 83% reported feelings of imposter phenomenon during their career. There was significant (p = 0.024) correlation between imposter phenomenon and burnout. Part 2 - Of 21 members of the Department of Radiology who completed the CIPS in the interactive workshop, 71% exhibited frequent or intense symptoms of imposter phenomenon. On the post-workshop survey asking participants to rate the workshop, the mean score was 4.4 and the mode score was 5 on a scale of 1 (poor) to 5 (excellent).

CONCLUSION: Imposter phenomenon affects radiologists and is correlated with burnout. Innovative interventions to address imposter phenomenon such as workshops utilizing medical improvisational techniques are well-received.

PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) remains a significant health issue. For most patients, there are no options for targeted therapy, and existing treatments are limited by toxicity. The HOPE trial (Harnessing Organoids for PErsonalized Therapy) was a pilot feasibility trial aiming to prospectively generate patient-derived organoids (PDO) from patients with PDAC and test their drug sensitivity and correlation with clinical outcomes.

EXPERIMENTAL DESIGN: PDOs were established from a heterogeneous population of patients with PDAC including both basal and classical PDAC subtypes.

RESULTS: A method for classifying PDOs as sensitive or resistant to chemotherapy regimens was developed to predict the clinical outcome of patients. Drug sensitivity testing on PDOs correlated with clinical responses to treatment in individual patients.

CONCLUSIONS: These data support the investigation of PDOs to guide treatment in prospective interventional trials in PDAC.

Imaging of mesothelioma plays a role in all aspects of patient management, including disease detection, staging, evaluation of treatment options, response assessment, pre-surgical evaluation, and surveillance. Imaging in this disease impacts a wide range of disciplines throughout the healthcare enterprise. Researchers and clinician-scientists are developing state-of-the-art techniques to extract more of the information contained within these medical images and to utilize it for more sophisticated tasks; moreover, image-acquisition technology is advancing the inherent capabilities of these images. This paper summarizes the imaging-based topics presented orally at the 2021 International Conference of the International Mesothelioma Interest Group (iMig), which was held virtually from May 7-9, 2021. These topics include an update on the mesothelioma staging system, novel molecular targets to guide therapy in mesothelioma, special considerations and potential pitfalls in imaging mesothelioma in the immunotherapy setting, tumor measurement strategies and their correlation with patient survival, tumor volume measurement in MRI and CT, CT-based texture analysis for differentiation of histologic subtype, diffusion-weighted MRI for the assessment of biphasic mesothelioma, and the prognostic significance of skeletal muscle loss with chemotherapy.

PURPOSE: The aim of this study was to investigate breast radiologists' practices related to recording sex and gender in the electronic medical record, knowledge and attitudes about breast cancer screening recommendations for transgender individuals, and experience and willingness to enter screening mammography data from transgender patients into databases that document service provision and outcomes of cancer detection protocols.

METHODS: A 19-question anonymous survey was distributed by e-mail to all active physician members of the Society of Breast Imaging. Response characteristics were assessed as frequencies and percentages and compared between groups using the Fisher exact test or χ2 test. The degree of agreement between questions was assessed using the McNemar test.

RESULTS: Four hundred one radiologists across the United States and Canada responded (response rate 18%). Recording birth-assigned sex distinct from gender identity was reported by 44 of 352 respondents (13%). Depending on geographic region, 38% to 62% of breast radiologists followed screening guidelines for transgender women, and 226 of 349 (65%) did not provide screening recommendations for transgender men. Of 400, 324 (81%) believed that the evidence base for screening transgender individuals is incomplete, and 247 of 352 (70%) were either unsure of or had no Lesbian, Gay, Bisexual, Transgender, Queer competency training. A majority (247 of 401 [62%]) of respondents reported that they would enroll transgender patients in existing or novel national databases.

CONCLUSIONS: In the practice of breast imaging, there is a substantial need to record transgender and other gender-nonconforming information. Breast radiologists differ in their practice and knowledge regarding screening of transgender women and men but expressed interest in contributing data to facilitate longitudinal databases needed to inform cancer screening guidelines.

PURPOSE: This study sought to define gender-related differences in attitudes, perceptions, and aspirations among trainees interested in interventional radiology (IR) and to analyze their experiences in research and mentorship.

MATERIALS AND METHODS: A cross-sectional survey study was conducted among the members of the Society of Interventional Radiology Resident, Fellow, and Student section and Medical Student section in the summer of 2020. The anonymous, internally validated 27-item survey assessed demographics, research attitudes and experiences, mentorship, and career aspirations. Descriptive statistics were calculated using Fisher exact analyses and Student t-tests. The institutional review board approved the protocols for this study.

RESULTS: Of 105 respondents who indicated their gender, 30% were women and 70% were men. Although both genders reported similar levels of research experience, female trainees were less likely to feel valued and encouraged by their institution to engage in research (2.79 out of 4 vs 3.16 out of 4, P = .02) and were less likely to indicate that their program required them to participate in research (2.47 vs 3.06, P = .01). Female residents and fellows reported more difficulty in finding a mentor (2.88 vs 3.28, P = .04) and received less mentorship relating to IR education (29% vs 64%, P = .002).

CONCLUSIONS: This work provides a perspective on the perceived obstacles faced by female trainees in pursuing research and finding effective mentorship in the field of IR. These data may guide future interventions to boost interest and engagement in IR research and residency programs in a way that promotes gender diversity and equity in the field.

OBJECTIVE: We evaluated whether there is an association between β-globin (HBB) pathogenic variants and fetal fraction (FF), and whether the association has a clinically relevant impact on non-invasive prenatal screening (NIPS).

METHOD: A whole-genome sequencing NIPS laboratory database was retrospectively queried for women who underwent NIPS and carrier screening of both HBB and the α-globin genes (HBA1/HBA2). Women affected with either condition were excluded from the study, yielding a cohort size of 15,853. A "corrected FF" was obtained via multivariable linear regression adjusted for the systematic impacts of maternal age, gestational age and BMI. Corrected FF distributions of HBB and HBA1/HBA2 carriers were each compared to non-carriers using the Kolmogorov-Smirnov test.

RESULTS: In this cohort, 291 women were carriers for HBB alone, and 1016 were carriers for HBA1/HBA2 alone. The HBB carriers had a lower corrected FF when compared to non-carriers (p < 0.0001). There was no difference in corrected FF among carriers and non-carriers of HBA1/HBA2.

CONCLUSION: Carriers of pathogenic variants in the HBB gene, but not the HBA1/HBA2 genes, are more likely to have lower FF when compared to women with structurally normal hemoglobin. This decrease in FF could result in an elevated test-failure rate if FF thresholds were used.