To determine an optimal embargo period preceding release of radiologic test results to an online patient portal. Materials and Methods: This prospective discrete choice conjoint survey with modified orthogonal design was administered to patients by trained interviewers at four outpatient sites and two institutions from December 2016 to February 2018. Three preferences for receiving imaging results associated with a possible or known cancer diagnosis were evaluated: delay in receipt of results (1, 3, or 14 days), method of receipt (online portal, physician's office, or phone), and condition of receipt (before, at the same time as, or after health care provider). Preferences (hereafter, referred to as utilities) were derived from parameter estimates (b) of multinomial regression stratified according to study participant and choice set. Results: Among 464 screened participants, the response and completion rates were 90.5% (420 of 464) and 99.5% (418 of 420), respectively. Participants preferred faster receipt of results (P , .001) from their physician (P , .001) over the telephone (P , .001). Each day of delay decreased preference by 13 percentage points. Participants preferred immediate receipt of results through an online portal (utility, 2.57) if made to wait more than 6 days to get results in the office and more than 11 days to get results by telephone. Compared with receiving results in their physician's office on day 7 (utility, 2.60), participants preferred immediate release through the online portal without physician involvement if followed by a telephone call within 6 days (utility, 20.49) or an office visit within 2 days (utility, 2.53). Older participants preferred physician-directed communication (P , .001). Conclusion: The optimal embargo period preceding release of results through an online portal depends on the timing of traditional telephone-and office-based styles of communication.

A retrospective analysis of 287 patients undergoing prophylactic radiation therapy for the prevention of heterotopic ossification,

Radiology is an important but underutilized tool for demonstrating concepts in bone physiology.

angiography (3DRA) compared to digital angiography orthogonal image pairs. Incorporation of 3DRA into the radiosurgery (RS) planning process in 2009 has since allowed for a frameless LINAC-based approach to treatment. We evaluated clinical outcomes for patients treated in the time since adopting this technique. Materials/Methods: Clinical data were queried for all patients treated at our institution for AVM by single-fraction RS from 2010 to present. Post-RS surveillance for nidus obliteration and radiation-induced changes (RIC) consisted of an MRI every six months for two years, then annually. Beyond two years, confirmatory cerebral angiography was recommended for any patient with MRI suggestive of nidus obliteration. Patients were excluded if they lacked sufficient post-RS radiographic assessment, defined as either MRI, CTA, or cerebral angiography at least two years after RS. Maximum diameter (MD) and volume were measured for each lesion and used to calculate a modified Radiosurgery-based AVM Score (mRBAS). RICs were identified and classified as radiologic, symptomatic, or permanent. Excellent outcome was defined as nidus obliteration without intracranial hemorrhage (ICH) or symptomatic/permanent RIC. Clinical predictors of study outcomes were identified through univariate and multivariate (MVA) logistic regression and backwards elimination was used to optimize a predictive model for each outcome. Results: A total of 65 AVMs in 62 patients were included with a median follow-up of 67 months. Median age at treatment was 31 years. Of these lesions, 58% presented with ICH. Prior intervention took place in 23% of cases. Median MD, volume, and mRBAS were 2.3cm, 1.93cc, and 1.16, respectively. 3DRA was utilized during treatment planning in 78% of cases. Treatments were delivered to a median isocenter and periphery dose of 2000 cGy and 1600 cGy, respectively. Obliteration was observed in 63% of cases with 88% confirmed angiographically. Median time-to-obliteration was 32 months. Radiologic, symptomatic, and permanent RICs developed in 40%, 8%, and 3% of cases, respectively. Post-RS ICH occurred in four patients with one ICH-related death. MVA showed that younger age and smaller MD predicted for obliteration. Larger MD predicted for radiologic RIC. Female gender and lower mRBAS predicted for excellent outcome. Conclusion: Incorporation of 3DRA in the RS planning process has allowed for a frameless approach to AVM treatment. Since instituting this technique, we have achieved obliteration and excellent outcome rates comparable to frame-based approaches with minimal treatment-related morbidity.