{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:48:14Z","timestamp":1762390094796,"version":"build-2065373602"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"11-12","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100006965","name":"Telemedicine and Advanced Technology Research Center","doi-asserted-by":"publisher","award":["#W81XWH-08-2-0162"],"award-info":[{"award-number":["#W81XWH-08-2-0162"]}],"id":[{"id":"10.13039\/100006965","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>High-resolution ultrasound can be utilized for the detection, localization, and characterization of both radiopaque and non-radiopaque soft tissue foreign bodies. However, ultrasonography as an intraoperative or percutaneous guidance method has not been systematically described in military-related wound management. The purpose of this study is to determine if ultrasound-guided foreign body removal (USFBR) taught in simulation improves radiologist technique and Foreign Body (FB) removal outcomes. Once the technique is mastered, the implementation of FB removals in Department of Defense (DoD) beneficiaries is studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this 2-phase study, USFBR simulation training was taught to 47 radiologists at 4 military treatment facilities over a 2-year period. Radiologists were assessed on FB removal techniques before and after 4 hours of individual hands-on training by a teaching team of 4 radiologists experienced in the technique. In the second phase of this study, clinical implementation of USFBR was documented on DoD beneficiaries. Institutional approval for each phase was obtained from the Internal Review Board of Nationwide Children\u2019s Hospital and National Navy Medical Center, Brooke Army Medical Center, Madigan Army Medical Center, and Tripler Army Medical Center review boards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Phase 1 training study demonstrated that the USFBR simulation training improved radiologists\u2019 scores from 21-52% pre-training to 90-100% post-training (P\u2009&amp;lt;\u2009.01 for each test component). Phase 2 clinical implementation demonstrated a 90% successful removal rate as defined by the complete removal of the FB from a DoD beneficiary under ultrasound guidance by a trained radiologist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study confirms that radiologists who complete simulation training can remove embedded FBs employing ultrasound imaging. Implementation of focused hands-on simulation training programs has the potential to improve ultrasonographic FB management practice. Implementation by trained radiologists was successful in removing FBs from DoD beneficiaries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaf282","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T07:41:50Z","timestamp":1748418110000},"page":"e2600-e2606","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-Guided Foreign Body Removal: Simulation Training and Clinical Implementation Outcomes"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5086-715X","authenticated-orcid":false,"given":"Megan","family":"Buras","sequence":"first","affiliation":[{"name":"Department of Medicine, John A Burns School of Medicine, University of Hawaii , Honolulu, HI 96813,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Clinical Investigation, Tripler Army Medical Center , Honolulu, HI 96859,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Matthew","family":"Meadows","sequence":"additional","affiliation":[{"name":"Department of Radiology, West Virginia University School of Medicine , Morgantown, WV 26506,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Carlson","sequence":"additional","affiliation":[{"name":"Department of Pediatric Imaging, Intermountain Primary Children\u2019s Hospital , Salt Lake City, UT 84113,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Krasnokutsky","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charlotte Radiology , Charlotte, NC 28202,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth M","family":"Helmreich","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nationwide Children\u2019s Hospital , Columbus, OH 43205,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nationwide Children's Hospital , Columbus, OH 43205,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica J","family":"Rooks","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tripler Army Medical Center , Honolulu, HI 96859,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"2025110519400931200_usaf282-B1","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1136\/jrnms-98-14","article-title":"Aggressive soft tissue infections and amputation in military trauma patients","volume":"98","author":"Penn-Barwell","year":"2012","journal-title":"J R Nav Med Serv"},{"key":"2025110519400931200_usaf282-B2","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.2214\/ajr.155.6.2122680","article-title":"Localization and guided removal of soft-tissue foreign bodies with sonography","volume":"155","author":"Shiels","year":"1990","journal-title":"AJR Am J Roentgenol"},{"key":"2025110519400931200_usaf282-B3","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1016\/j.cult.2007.12.001","article-title":"Soft tissue foreign bodies: sonographic diagnosis and therapeutic management","volume":"2","author":"Shiels","year":"2007","journal-title":"Ultrasound Clin"},{"key":"2025110519400931200_usaf282-B4","doi-asserted-by":"publisher","first-page":"760","DOI":"10.2214\/ajr.133.4.760","article-title":"Real-time ultrasound guidance for percutaneous transluminal retrieval of nonopaque intravascular catheter fragment","volume":"133","author":"Woo","year":"1979","journal-title":"AJR Am J Roentgenol"},{"key":"2025110519400931200_usaf282-B5","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1097\/IOP.0b013e3181aadafe","article-title":"Percutaneous ultrasound-guided intraorbital foreign body removal","volume":"25","author":"Close","year":"2009","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"2025110519400931200_usaf282-B6","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/j.tripleo.2005.02.072","article-title":"Intraoperative imaging techniques: a guide to retrieval of foreign bodies","volume":"100","author":"Holmes","year":"2005","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"2025110519400931200_usaf282-B7","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1002\/jcu.22856","article-title":"Soft tissue foreign bodies: a training manual for sonographic diagnosis and guided removal","volume":"48","author":"Rooks","year":"2020","journal-title":"J Clin Ultrasound"},{"key":"2025110519400931200_usaf282-B8","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1148\/radiol.10091566","article-title":"Self-embedded behavior: radiological management of self-inflicted soft-tissue foreign bodies","volume":"257","author":"Young","year":"2010","journal-title":"Radiology"},{"key":"2025110519400931200_usaf282-B9","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1016\/j.otc.2010.08.010","article-title":"Head and neck ultrasound in the pediatric population","volume":"43","author":"Rooks","year":"2010","journal-title":"Otolaryngol Clin North Am"},{"key":"2025110519400931200_usaf282-B10","doi-asserted-by":"publisher","first-page":"988","DOI":"10.7205\/MILMED-D-11-00450","article-title":"Sonographic localization and management of metallic fragments: a report of five cases","volume":"177","author":"Harcke","year":"2012","journal-title":"Mil Med"},{"key":"2025110519400931200_usaf282-B11","doi-asserted-by":"publisher","first-page":"567","DOI":"10.2214\/ajr.147.3.567","article-title":"Sonographic diagnosis of foreign bodies of the distal extremities","volume":"147","author":"Fornage","year":"1986","journal-title":"Am J Roentgenol"},{"key":"2025110519400931200_usaf282-B12","doi-asserted-by":"publisher","first-page":"217","DOI":"10.7863\/jum.1987.6.4.217","article-title":"Sonographic preoperative localization of a foreign body in the hand","volume":"6","author":"Fornage","year":"1987","journal-title":"J Ultrasound Med"},{"key":"2025110519400931200_usaf282-B13","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1016\/s0002-9378(98)70321-7","article-title":"Real-time ultrasonographically guided removal of nonpalpable and intramuscular Norplant capsules","volume":"178","author":"Nelson","year":"1998","journal-title":"Am J Obstet Gynecol"},{"key":"2025110519400931200_usaf282-B14","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1097\/01241398-199803000-00024","article-title":"Intraoperative sonography-\u00adguided removal of radiolucent foreign bodies","volume":"18","author":"Leung","year":"1998","journal-title":"J Pediatr Orthop"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/11-12\/e2600\/63464328\/usaf282.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/11-12\/e2600\/63464328\/usaf282.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:40:14Z","timestamp":1762389614000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/190\/11-12\/e2600\/8159921"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,4]]},"references-count":14,"journal-issue":{"issue":"11-12","published-online":{"date-parts":[[2025,6,4]]},"published-print":{"date-parts":[[2025,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf282","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"type":"print","value":"0026-4075"},{"type":"electronic","value":"1930-613X"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,6,4]]}}}