Value-Based Radiology in Neuro/Head and Neck Imaging

  • David RodriguesEmail author
Part of the Medical Radiology book series (MEDRAD)


In this chapter, four case scenarios are presented where many common questions and issues are frequently dealt in the field of Neuro and Head and Neck Imaging, where radiologists can bring added value through their expertise input, when patient outcome can clearly be improved, like the diagnosis and management of ischemic stroke, thyroid nodules or low back pain, or the help in the diagnosis of minor head trauma.


  1. ACR TI-RADS Webinar II (2019). Accessed 29 Jan 2019
  2. American College of Radiology Appropriateness Criteria® (2019). Accessed 29 Jan 2019
  3. Anselmetti GC, Marras M (2017) RF for treatments of benign lesions. In: Marcia S, Saba L (eds) Radiofrequency treatments on the spine. Springer, ChamGoogle Scholar
  4. Autio RA, Karppinen J, Niinimaki J et al (2006) Determinants of spontaneous resorption of intervertebral disc herniations. Spine (Phila Pa 1976) 31(11):1247–1252CrossRefGoogle Scholar
  5. Berkhemer OA, Fransen PS, Beumer D et al, MR CLEAN Investigators (2015) A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med 372:11–20Google Scholar
  6. Campbell BC, Mitchell PJ, Kleinig TJ et al, EXTEND-IA Investigators (2015) Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med 372:1009–1018Google Scholar
  7. Cheng AL, Batool S, McCreary CR et al (2013) Susceptibility-weighted imaging is more reliable than T2*-weighted gradient-recalled echo MRI for detecting microbleeds. Stroke 44(10):2782–2786CrossRefGoogle Scholar
  8. Choosing Wisely® (2019) The American Board of Internal Medicine Foundation. Accessed 29 Jan 2019
  9. Chou R, Fu R, Carrino JA, Deyo RA (2009) Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet 373(9662):463–472CrossRefGoogle Scholar
  10. Dayan PS, Ballard DW, Tham E et al, Pediatric Emergency Care Applied Research Network, Clinical Research on Emergency Services and Treatment Network, Partners Healthcare, Traumatic Brain Injury-Knowledge Translation Study Group (2017) Use of traumatic brain injury prediction rules with clinical decision support. Pediatrics 139(4):e20162709CrossRefGoogle Scholar
  11. Edwards J, Hayden J, Asbridge M et al (2017) Prevalence of low back pain in emergency settings: a systematic review and meta-analysis. BMC Musculoskelet Disord 18:143. CrossRefPubMedPubMedCentralGoogle Scholar
  12. Fried JG, Andrew AS, Ring NY, Pastel DA (2018) Changes in primary care health care utilization after inclusion of epidemiologic data in lumbar spine MR imaging reports for uncomplicated low back pain. Radiology 287(2):563–569CrossRefGoogle Scholar
  13. Georgy BA, Marini S, Piras E (2017) RF for treatments of malignant lesions. In: Marcia S, Saba L (eds) Radiofrequency treatments on the spine. Springer, ChamGoogle Scholar
  14. Gilligan C, Malik OS, Hirsch JA (2017) Radiofrequency ablation for sacroiliac joint pain. In: Marcia S, Saba L (eds) Radiofrequency treatments on the spine. Springer, ChamGoogle Scholar
  15. Goyal M, Demchuk AM, Menon BK et al, ESCAPE Trial Investigators (2015) Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med 372:1019–1030Google Scholar
  16. Grant EG, Tessler FN, Hoang JK et al (2015) Thyroid ultrasound reporting lexicon: white paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol 12(12 Pt A):1272–1279CrossRefGoogle Scholar
  17. Hoang JK, Middleton WD, Farjat AE et al (2018) Reduction in thyroid nodule biopsies and improved accuracy with American College of Radiology Thyroid Imaging Reporting and Data System. Radiology 287(1):185–193CrossRefGoogle Scholar
  18. Jarvik JG, Gold LS, Comstock BA et al (2015a) Association of early imaging for back pain with clinical outcomes in older adults. JAMA 313(11):1143–1153CrossRefGoogle Scholar
  19. Jarvik JG, Comstock BA, James KT et al (2015b) Lumbar imaging with reporting of epidemiology (LIRE)—protocol for a pragmatic cluster randomized trial. Contemp Clin Trials 45(Pt B):157–163CrossRefGoogle Scholar
  20. Jennings RM, Burtner JJ, Pellicer JF et al (2017) Reducing head CT use for children with head injuries in a community emergency department. Pediatrics 139(4):e20161349CrossRefGoogle Scholar
  21. Jovin TG, Chamorro A, Cobo E et al, REVASCAT Trial Investigators (2015) Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med 372:2296–2306CrossRefGoogle Scholar
  22. Kelekis A, Filippiadis DK (2017) RFN on lumbar facet joint. In: Marcia S, Saba L (eds) Radiofrequency treatments on the spine. Springer, ChamGoogle Scholar
  23. Kim SH, Park CS, Jung SL et al (2010) Observer variability and the performance between faculties and residents: US criteria for benign and malignant thyroid nodules. Korean J Radiol 11(2):149–155CrossRefGoogle Scholar
  24. Kim HG, Kwak JY, Kim EK, Choi SH, Moon HJ (2012) Man to man training: can it help improve the diagnostic performances and interobserver variabilities of thyroid ultrasonography in residents? Eur J Radiol 81(3):e352–e356CrossRefGoogle Scholar
  25. Kuppermann N, Holmes JF, Dayan PS et al (2009) Identification of children at very low-risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374(9696):1160–1170CrossRefGoogle Scholar
  26. Lansberg MG, Straka M, Kemp S et al (2012) MRI profile and response to endovascular reperfusion after stroke (DEFUSE 2): a prospective cohort study. Lancet Neurol 11(10):860–867CrossRefGoogle Scholar
  27. Lauria A, Maddaloni E, Briganti SI, Beretta Anguissola G, Perrella E, Taffon C et al (2018) Differences between ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications performance in identifying cytological high-risk thyroid nodules. Eur J Endocrinol 78:595–603CrossRefGoogle Scholar
  28. Machado GC, Richards B, Needs C et al (2018) Implementation of an evidence-based model of care for low back pain in emergency departments: protocol for the Sydney Health Partners Emergency Department (SHaPED) trial. BMJ Open 8(4):e019052. Published 19 Apr 2018. CrossRefPubMedPubMedCentralGoogle Scholar
  29. Manchikanti L, Kaye AD, Boswell MV et al (2015) A systematic review and best evidence synthesis of the effectiveness of therapeutic facet joint interventions in managing chronic spinal pain. Pain Physician 18(4):E535–E582PubMedGoogle Scholar
  30. Manchikanti L, Pampati V, Kaye AD, Hirsch JA (2018) Therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain: cost utility analysis based on a randomized controlled trial. Korean J Pain 31(1):27–38CrossRefGoogle Scholar
  31. MDCalc (2019). Accessed 29 Jan 2019
  32. Nigrovic LE, Stack AM, Mannix RC et al (2015) Quality improvement effort to reduce cranial CTs for children with minor blunt head trauma. Pediatrics 136(1):e227–e233CrossRefGoogle Scholar
  33. Oltmann SC, Schneider DF, Chen H, Sippel RS (2014) All thyroid ultrasound evaluations are not equal: sonographers specialized in thyroid cancer correctly label clinical N0 disease in well differentiated thyroid cancer. Ann Surg Oncol 22(2):422–428CrossRefGoogle Scholar
  34. Powers WJ, Derdeyn CP, Biller J et al (2015) 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 46(10):3020–3035CrossRefGoogle Scholar
  35. Raguso M, Marsico S, Fiori R, Masala S (2017) Discogenic low back pain and radicular pain: therapeutic strategies and role of radio-frequency techniques. In: Marcia S, Saba L (eds) Radiofrequency treatments on the spine. Springer, ChamGoogle Scholar
  36. Rosario PW (2010) Ultrasonography for the follow-up of patients with papillary thyroid carcinoma: how important is the operator? Thyroid 20(7):833–834CrossRefGoogle Scholar
  37. Sacks D, van Overhagen H, van Zwam WH et al (2019) The role of interventional radiologists in acute ischemic stroke interventions: a joint position statement from the Society of Interventional Radiology, the Cardiovascular and Interventional Radiology Society of Europe, and the Interventional Radiology Society of Australasia. J Vasc Interv Radiol 30(2):131–133CrossRefGoogle Scholar
  38. Saver JL, Goyal M, Bonafe A et al, SWIFT PRIME Investigators (2015) Stentretriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med 372:2285–2295CrossRefGoogle Scholar
  39. Shireman TI, Wang K, Saver JL et al, SWIFT PRIME Investigators (2017) Cost-effectiveness of Solitaire stent retriever thrombectomy for acute ischemic stroke: results from the SWIFT-PRIME Trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke). Stroke 48:379–387Google Scholar
  40. Tessler FN, Middleton WD, Grant EG et al (2017) ACR thyroid imaging, reporting and data system (TI-RADS): white paper of the ACR TI-RADS committee. J Am Coll Radiol 14(5):587–595CrossRefGoogle Scholar
  41. Tessler FN, Middleton WD, Grant EG (2018) Thyroid imaging reporting and data system (TI-RADS): a user’s guide. Radiology 287(1):29–36CrossRefGoogle Scholar
  42. Verma RK, Kottke R, Andereggen L et al (2013) Detecting subarachnoid hemorrhage: comparison of combined FLAIR/SWI versus CT. Eur J Radiol 82(9):1539–1545CrossRefGoogle Scholar
  43. Yoo AJ, Verduzco LA, Schaefer PW, Hirsch JA, Rabinov JD, Gonzalez RG (2009) MRI-based selection for intra-arterial stroke therapy: value of pretreatment diffusion-weighted imaging lesion volume in selecting patients with acute stroke who will benefit from early recanalization. Stroke 40(6):2046–2054CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG  2019

Authors and Affiliations

  1. 1.Imaging DepartmentVila Franca de Xira HospitalVila Franca de XiraPortugal

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