title: Utilizing a PACS-integrated ultrasound-guided breast biopsy simulation exercise to reinforce the ACR practice guideline for ultrasound-guided percutaneous breast interventional procedures during radiology residency.
abstract: OBJECTIVE
  A picture archiving and communication system (PACS)-integrated ultrasound-guided (USG) breast intervention simulation exercise was designed for radiology residency education. The purpose of this study was to describe the initial experience and determine if resident understanding of the American College of Radiology (ACR) practice guideline for the performance of USG percutaneous breast interventional procedures and procedural confidence is improved with the implementation of this simulation exercise.
  
  
  METHODS
  Radiology residents (n = 11) volunteered to perform percutaneous USG cyst aspiration, 14-gauge automated core biopsy, and 10-gauge vacuum core biopsy on turkey breast phantoms, with an emphasis on capturing ultrasound images demonstrating appropriate documentation of the procedure and image annotation according to the ACR practice guideline for USG percutaneous interventions. The images were transmitted to the PACS for subsequent attending radiologist review. Survey responses regarding procedural confidence and knowledge of the ACR practice guideline were compared between residents with and without the simulator experience.
  
  
  RESULTS
  Residents with simulation exercise experience showed statistically significant increases in confidence performing USG core biopsies, operating biopsy devices and ultrasound equipment, and knowledge of appropriate needle positioning and image annotation and documentation according to the ACR practice guideline. The increased confidence seen in performing USG cyst aspiration barely missed statistical significance (P = .056), likely because of residents' baseline familiarity with the procedure.
  
  
  CONCLUSIONS
  A PACS-integrated USG breast intervention simulation exercise increases residents' procedural confidence and understanding of the ACR practice guideline for the performance of USG percutaneous breast interventional procedures.
authors: Department of Radiology, Breast Imaging Section, Stanford University School of Medicine, CA 94305, USA.
authors: Kenneth
authors: K
authors: Meng
authors: Jafi A
authors: JA
authors: Lipson
mesh_terms: D000818:Animals; D001707:Biopsy, Needle / Q000379:methods*; D001940:Breast / Q000473:pathology*; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D007396:Internship and Residency; D019047:Phantoms, Imaging; D017410:Practice Guidelines as Topic; D011871:Radiology / Q000193:education*; D011873:Radiology Information Systems; D014422:Turkeys; D018084:Ultrasonography, Interventional