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Pacsman Pontification
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Podcast: The PACSMan Pontificates, Episode 2 -- RFPs
Are RFPs still needed for buying a PACS? Michael J. Cannavo, aka the PACSMan, tackles this question in episode 2 of The PACSMan Pontificates podcast series.
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A 44-year-old woman with TFCC injury treated by transcatheter arterial embolization (TAE). a) Right brachial arteriography via common femoral artery access with a 5-Fr catheter demonstrates hyperstaining on the ulnar side of the wrist joint (white circle). b) An ulnar artery branch is superselected with a 1.9-Fr microcatheter, showing hypervascular staining corresponding to the pain site (white arrow). c) Delayed-phase angiography reveals early venous drainage (white arrow) adjacent to the hyperstaining, a finding often observed in TAE and considered an additional marker for embolization. d) Final angiography after injection of 0.5 mL quick-soluble gelatin sponge particles (QS-GSPs) demonstrates resolution of the hyperstaining (white circle). The VAS pain score improved from 7 at baseline to 1 at six months.
Interventional
TAE reduces pain in patients with chronic wrist pain
Case example of a false-negative AI result. An 85-year-old female presented to the emergency department with dyspnea. Axial 0.625-mm from CT pulmonary angiography examination with contrast (CTPA) images demonstrate a thin, linear right-sided filling defect extending from the right interlobar pulmonary artery (A and B, red arrows) into the right middle lobar artery (B, yellow arrow), consistent with acute pulmonary embolism (PE). The finding was described in the radiology report; however, the AI result was negative for PE. Adjudication was consistent with acute PE.
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Human-AI collaboration beats AI alone for identifying PE
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Cropped secondary capture examples. These are illustrative and not intended to imply superiority or inferiority of any device. (A) Posteroanterior radiograph in a 46-year-old female patient. The device correctly identified a right lower lobe nodule projected below the right hemidiaphragm and hilar lymphadenopathy. (B) Posteroanterior radiograph in an 86-year-old female patient with a classic Golden S sign highly suggestive of cancer. Three devices did not identify any findings. (C) The output from one device for the same radiograph as in B. The device placed a contour around the area of abnormality but mislabeled it as segmental collapse, and there are no other elements in the output to raise suspicion of cancer. (D) Posteroanterior radiograph in a 60-year-old male patient -- a case of confirmed lung cancer that was not deemed visible in retrospect. The device identified multiple false-positive abnormalities. (E) Posteroanterior radiograph in a 77-year-old female patient with two right lower lobe nodules. The device mislabeled the abnormality as infection -- a diagnostic term that could incorrectly influence clinical management. (F) Posteroanterior radiograph in a 77-year-old female patient with a right hilar tumor. Most of the lungs have been labeled by the device, with excessive overlap of the abnormality that pragmatically represents an incorrect result. All annotations shown were produced by the devices. LL = lung lesion, LO = lung opacity, PO = pleural other, TBC = tuberculosis.
AI devices vary widely in lung cancer detection
May 19, 2026
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Podcast: The PACSMan Pontificates, Episode 2 -- RFPs
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A 44-year-old woman with TFCC injury treated by transcatheter arterial embolization (TAE). a) Right brachial arteriography via common femoral artery access with a 5-Fr catheter demonstrates hyperstaining on the ulnar side of the wrist joint (white circle). b) An ulnar artery branch is superselected with a 1.9-Fr microcatheter, showing hypervascular staining corresponding to the pain site (white arrow). c) Delayed-phase angiography reveals early venous drainage (white arrow) adjacent to the hyperstaining, a finding often observed in TAE and considered an additional marker for embolization. d) Final angiography after injection of 0.5 mL quick-soluble gelatin sponge particles (QS-GSPs) demonstrates resolution of the hyperstaining (white circle). The VAS pain score improved from 7 at baseline to 1 at six months.
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TAE reduces pain in patients with chronic wrist pain
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Pacsman Pontification
Podcast Network
Podcast: The PACSMan Pontificates, Episode 2 -- RFPs
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