iiinova — where your digital self keeps evolving

Francis Deng, MD @francisdeng.medsky.social · 23/03/2026

Medical specialty-specific compensation vs. annual hours worked, based on Marit 2026 survey data

Francis Deng, MD @francisdeng.medsky.social · 19/11/2025

Routine sinus CT in patients with fever and neutropenia has low clinical impact. In this @theajnr.bsky.social video podcast, Rohini Nadgir explains: youtu.be/hYTjdb-lZxI?...

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Francis Deng, MD @francisdeng.medsky.social · 07/05/2025

Bad news: CTA head and CTA neck will be bundled into one CPT code starting in 2026, which portends a reimbursement cut (it was ~25% when CT abdomen+pelvis were bundled in 2011). Good news: CT perfusion will have its own category I CPT code separate from CTA head, which may improve reimbursement.

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Francis Deng, MD @francisdeng.medsky.social · 03/05/2025

Head and neck radiology case review at 4pm EST today RadDiscord members can register here us06web.zoom.us/meeting/regi... Brand new content, 33 MCQs, 30s each, competition style. My prior reviews here: youtu.be/9RJr7h9dJVI youtu.be/bepptfOXV2U

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Francis Deng, MD @francisdeng.medsky.social · 01/05/2025

Radiology in #ERAS2026 is changing to separate signals for integrated IR/DR (8 signals) and DR programs (6 gold and 9 silver signals). I’d advise applicants looking to maximize their chances of matching to apply to both. youtu.be/plryJQb6-qY?...

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Francis Deng, MD @francisdeng.medsky.social · 22/04/2025

Medical specialties differed in the degree to which residencies favored applicants from certain racial, ethnic, or nationality groups in the Match. @jennyxchen.bsky.social @jgmejournal.bsky.social meridian.allenpress.com/jgme/article...

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Francis Deng, MD @francisdeng.medsky.social · 13/04/2025

Med students applying to residency: check out this site for program rankings (from Doximity) and Step 2 averages (from Residency Explorer) in one place residency.admit.org/program-stat...

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Francis Deng, MD @francisdeng.medsky.social · 12/03/2025

At #AAR25 keynote, Desiree Morgan advises us in times of change to keep in view your ‘horizon point’ - who/what you want to be in the future, eg, “an influential radiologist” and what that means

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Francis Deng, MD @francisdeng.medsky.social · 01/02/2025

"Leaders and educators throughout medicine therefore have a Herculean task: to optimize physician wellness while maintaining clinical excellence." John Benson in AJNR www.ajnr.org/content/earl...

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Francis Deng, MD @francisdeng.medsky.social · 05/01/2025

Young woman with headaches. What is the radiological diagnosis? This one has path proof (🤔) Featured as @radiopaedia.org Case of the Day recently doi.org/10.53347/rID...

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Francis Deng, MD @francisdeng.medsky.social · 29/12/2024

Half of cancer patients in this study experienced a care delay related to prior authorization for imaging. Doi.org/10.1001/jamanetworkopen.2023.38182

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Francis Deng, MD @francisdeng.medsky.social · 29/12/2024

As the proportion of US medical school graduates is increasingly female, traditionally male-dominated specialties have also seen increases in female representation. But radiology is lagging others. Why? buff.ly/3DBPagf Hunt et al. in JACR

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Francis Deng, MD @francisdeng.medsky.social · 29/12/2024

2024 Images in Radiology - editors' choices 1) disseminated cysticercosis (by Ilyas, Mahajan) 2) uremic leontiasis ossea (Lakhani, Deng) 3) diffuse cerebral proliferative angiopathy (Lakhani, Boo) doi.org/10.1148/radi...

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Francis Deng, MD @francisdeng.medsky.social · 28/12/2024

Dilated internal vertebral venous plexus (due to low CSF pressure from overshunting)

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Francis Deng, MD @francisdeng.medsky.social · 28/12/2024

Relevant quantitative/semi-quantitative descriptors for burst fractures: -vertebral body height loss: here 70% ("severe": >40% per Genant system [see figure]) -spinal canal stenosis: here 50% ("moderate": 1/3 to 2/3 per NASS/ASSR/ASNR)

$Genant semiquantitative system of vertebral fracture classification as depicted in Wang YX et al. Quant Imaging Med Surg 2017 doi:10.21037/qims.2017.10.05$

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Francis Deng, MD @francisdeng.medsky.social · 28/12/2024

What are the important descriptors of this spinal fracture? "Compression fracture" is not enough to convey severity/risk. -both endplates involved -posterior cortex distinctly involved, w/ retropulsion Classification: AO Spine: "complete burst" (A4) AO Spine-DGOU Osteoporotic Fracture: OF4 #Radsky

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Francis Deng, MD @francisdeng.medsky.social · 24/12/2024

Patients can now read their reports through online portals. Perhaps there will be a greater role for radiologists in the future to write patient-friendly summaries and/or communicate results directly to the patient.

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Francis Deng, MD @francisdeng.medsky.social · 24/12/2024

This incident highlights that the process of diagnosis does not end with a radiologist signing off a report. That interpretation has to be translated, typically by another clinician, to the patient. The definition of diagnostic error includes failure to communicate a diagnosis to the patient.

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Francis Deng, MD @francisdeng.medsky.social · 24/12/2024

The autopsy indicated the cause of death was complications of the mediastinal mass, which was T-cell lymphoblastic lymphoma. Had the result of mediastinal adenopathy been properly communicated, worked up, and managed in the hospital setting, plaintiffs alleged, the patient would not have died.

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Francis Deng, MD @francisdeng.medsky.social · 24/12/2024

Failure to effectively communicate Teen presented to ED with chest pain and shortness of breath. A CXR was reported below but the pt/family were led to believe it was normal and discharged home. He died 3 days later. Hospital accepted responsibility for misdiagnosis and settled for $16 million.

Impression: Widened mediastinum lossibly mediastinal lymphadenopathy. Contrast-enhanced CT scan of the chest recommended.

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Francis Deng, MD @francisdeng.medsky.social · 20/12/2024

Do you know the name of the normal variant? Answer: doi.org/10.1007/s00276-011-0831-9 #Radsky #neurorad

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Francis Deng, MD @francisdeng.medsky.social · 20/12/2024

50yo M presents with 6 days of declining visual acuity and is found to have bilateral optic disc edema. What is the likely diagnosis based on this image? My case of the day on @radiopaedia.org Answer: doi.org/10.53347/rID...

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Francis Deng, MD @francisdeng.medsky.social · 15/12/2024

"Vision-capable large language models cannot effectively use images to increase performance on radiology board-style examination questions." doi.org/10.1016/j.ac...

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Francis Deng, MD @francisdeng.medsky.social · 04/12/2024

Radiology residents and fellows can apply to join any of the RSNA journals’ trainee editorial board each year with apps open in April. Mark it on your calendar if you are interested in publishing and editorial work #RSNA24 www.rsna.org/education/tr...

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Francis Deng, MD @francisdeng.medsky.social · 04/12/2024

One feature of a high reliability organization is a preoccupation with failure. Jay Pahade at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 04/12/2024

How to conduct a root cause analysis: Define what happened and keep asking “why?” — 5 times. Nadja Kadom at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 03/12/2024

Orbital venous malformations (don’t call it a hemangioma), have very high T2 signal intensity, higher than brain. @dshatzkes.bsky.social at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 03/12/2024

When it comes to salivary tumors, our job is not to predict the histologic type. But we can use MR to predict benign or malignant and help risk-stratify indeterminate or unexpected FNA results. Don’t forget to use ADC to help! @cmglastonbury.bsky.social at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 03/12/2024

If you’re looking for a parathyroid adenoma and find none, maybe it’s that thyroid nodule. Intrathyroidal parathyroid adenoma! Doug Phillips at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 03/12/2024

Get your summary roast of your bsky profile here h/t @rasushrestha.bsky.social blueskyroast.com

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Francis Deng, MD @francisdeng.medsky.social · 02/12/2024

Come on down to Arie Crown Theater for the #RSNA24 Fast 5 followed by the Image Interpretation Session. Doors are open and the seating capacity is more than 4k!

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Francis Deng, MD @francisdeng.medsky.social · 02/12/2024

Enhancing facial nerve? Don’t be quick to call it Bell’s palsy. Follow-up is needed. If weakness/enhancement persist without improvement for many months, think of perineural tumor spread. Hillary Kelly at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 02/12/2024

For hard palate cancers, watch out for perineural tumor spread via the greater/lesser palatine nerves to pterygopalatine fossa. Know where the palatine canal is: @cynxinwu.bsky.social at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 01/12/2024

Do patients want to speak to radiologists about their results? It depends on the setting and circumstance but sometimes yes! Colbey Freeman at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 01/12/2024

AI can be a safety-net critical finding detector that prompts a second radiologist read, averting this many millions of malpractice indemnity payments a year in a 500+ radiologist telerad practice (vRad) Benjamin Strong at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 01/12/2024

Top tip for effective communication in radiology: Use diagnosis words, not radiology jargon. Matthew Davenport at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 01/12/2024

Radiologists are information brokers. Communication is central to our business. We translate imaging data to change provider behavior and improve patient outcomes. Ask yourself, how can I optimize communication to create value? Matthew Davenport at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 01/12/2024

Primary care doctors often have questions for radiologists and would love to be able to e-consult radiology. This way, communications are asynchronous (convenient) and documented in the EMR (clear). Hanna Zafar at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 01/12/2024

Report with standardized expressions of uncertainty, “normal” when appropriate, and clear recommendations for follow-up. Atul Shinagare at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 01/12/2024

Communication errors are harmful and common in radiology malpractice claims. Bettina Siewert at #RSNA24

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Francis Deng, MD @francisdeng.medsky.social · 30/11/2024

What are the core elements of a hospital diagnostic excellence program? Here the CDC provides a shared mental model for how it works. (Radiology and laboratory testing experts are one key part!) buff.ly/3B9c5P5

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Francis Deng, MD @francisdeng.medsky.social · 24/11/2024

If a patient presents with an orthostatic headache after a recent lumbar puncture, MRI of the total spine is usually not warranted!!! Thanks, your friendly neighborhood neuroradiologist, now supported by new ACR Appropriateness Criteria: doi.org/10.1016/j.ja...

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Francis Deng, MD @francisdeng.medsky.social · 24/11/2024

Surgeons were more likely than medicine doctors to disagree with a radiologist's recommending for follow-up imaging. doi.org/10.1016/j.ja...

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Francis Deng, MD @francisdeng.medsky.social · 24/11/2024

Old infarcts are an incredibly common and underreported incidental finding in ED head CTs, apparently more than a third of which are not known to the patient or clinicians. Should we make a better effort to draw attention to these so some may receive secondary prevention? doi.org/10.1016/j.ja...

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Francis Deng, MD @francisdeng.medsky.social · 23/11/2024

Adjunctive middle meningeal artery embolization, in addition to surgery, for subacute or chronic unilateral subdural hematoma was effective in reducing hematoma recurrence compared to surgery alone, with a 2% risk of serious adverse event like stroke. doi.org/10.1056/NEJMoa2313472

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Francis Deng, MD @francisdeng.medsky.social · 23/11/2024

If an AI diagnostic/detection aid can put an explanatory box around the imaging feature, physicians find this much more trustworthy and efficient than a global explanation. From Paul Yi and Chien-Ming Huang in Radiology doi.org/10.1148/radi...

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Francis Deng, MD @francisdeng.medsky.social · 23/11/2024

AI use was associated with higher radiologist burnout, moderated by higher workloads. doi.org/10.1001/jama...

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