Leadership has emerged as a core competency for Canadian radiologists navigating an era of challenges, including the integration of artificial intelligence, regional service consolidation, value-based care, and growing administrative complexity. Yet formal leadership training remains underrepresented in radiology training and in continuing professional development. This article synthesizes contemporary leadership scholarship into a practical framework for radiologist development and is based on the first module of the CAR leadership course. Six interlocking concepts are examined: (1) leadership as an ongoing journey rather than a positional title; (2) authentic, self-aware leadership grounded in the "incomplete leader" model of distributed capabilities; (3) adaptability across leadership styles; (4) team chemistry and cognitive diversity; (5) the first 100 days of a new leadership role; and (6) mentorship as both a developmental obligation and a hedge against burnout. Effective leadership in radiology is learnable, but not by a checklist. It requires interactive education, reflective self-assessment, deliberate construction of complementary teams, intentional onboarding, and a sustained commitment to mentoring the next generation. The Canadian Association of Radiologists, in concert with Canadian Radiology departments and the Canadian Heads of Academic Radiology (CHAR), has taken on the task of formalizing these elements into structured programming that can meet the needs of busy radiologists.

Acute non-traumatic urinary tract emergencies are a frequent cause of emergency department presentation and may result in significant morbidity if not promptly diagnosed. Imaging plays a pivotal role in identifying the underlying pathology, assessing disease severity, and guiding patient management. This review provides a comprehensive imaging-based overview of the most common acute non-traumatic urinary tract emergencies. Obstructive, infectious, vascular, and hemorrhagic conditions, as well as urinary leaks, are discussed with emphasis on their characteristic imaging findings. The roles of ultrasound, computed tomography, and magnetic resonance imaging are reviewed, highlighting appropriate modality selection in the emergency setting. In addition, the emerging role of photon-counting computed tomography (PCCT) is discussed. Owing to its improved spatial resolution, enhanced tissue contrast, and spectral imaging capabilities, PCCT may allow better detection of subtle parenchymal abnormalities, small calculi, vascular alterations, and urinary leaks, while potentially enabling dose optimization. Key diagnostic features, common pitfalls, and practical reporting considerations are presented to assist radiologists in achieving timely and accurate diagnoses. This review aims to support a systematic and clinically relevant imaging approach to acute non-traumatic urinary tract emergencies.

Focused Abbreviated Survey Technique (FAST) MRI protocols address the clinical challenges of prolonged scan times, sedation requirements, and ionizing radiation exposure in pediatric neuroimaging. These guidelines, developed by the Canadian Society of Pediatric Radiology (CanSPR), provide evidence-informed recommendations to assist practitioners in the selective application of abbreviated MRI protocols across diverse clinical scenarios. Based on comprehensive literature review and expert consensus, the working group established a framework for using FAST MRI as a targeted, CT-sparing strategy. The guideline outlines protocols and indications for the follow-up of hydrocephalus, arachnoid cysts, and syringomyelia. It also addresses its application in acute settings, including suspected stroke, first-time seizures, and accidental trauma, as well as its role in evaluating macrocrania following inconclusive ultrasound and headaches. While FAST MRI facilitates timely diagnosis and improves safety by minimizing anesthesia, it may have lower spatial resolution than conventional protocols. Consequently, these recommendations emphasize its use for targeted diagnostic questions rather than as a replacement for comprehensive MRI examinations.

Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible neurological disorder characterized by the triad of gait disturbance, cognitive decline, and urinary dysfunction in association with ventriculomegaly and normal or mildly elevated cerebrospinal fluid (CSF) pressure. Although first described by Hakim in 1957, the condition remains underdiagnosed, partly because its clinical manifestations are common in the elderly population and are often attributed to more prevalent age-related conditions. The pathophysiology of iNPH is complex and incompletely understood, involving alterations in CSF dynamics, reduced vascular compliance, periventricular ischemia, and dysfunction of the glymphatic system, potentially leading to the accumulation of neurotoxic metabolites and neuronal impairment. Neuroradiological studies, particularly MRI, play a central role in diagnosis. MRI is essential to exclude alternative causes of ventriculomegaly and to identify characteristic imaging features such as a reduced callosal angle and the disproportionately enlarged subarachnoid space hydrocephalus (DESH) pattern, which support the diagnosis, although their predictive value for treatment response remains limited. Complementary non-imaging tests are often required to identify patients most likely to benefit from CSF shunting. Recent MRI advances have introduced biomarkers of glymphatic dysfunction, such as diffusion tensor imaging along perivascular spaces (DTI-ALPS), which may improve understanding of disease mechanisms and refine patient selection. Early recognition and accurate imaging assessment are crucial, given the potential reversibility of symptoms after shunt surgery.