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  • Journal Highlights

    The following are highlights from the current issues of RSNA’s two peer-reviewed journals.

    May 1, 2017

    Financial Forecasting and Stochastic Modeling: Predicting the Impact of Business Decisions

    For radiologists whose role it is to oversee the delivery of imaging services and the interpretation, communication and curation of imaging-informed information, business decisions influence where and how they practice, the tools available for image acquisition and interpretation, and ultimately their professional satisfaction.

    In a review article in the May issue of Radiology (RSNA.org/Radiology), co-authors Geoffrey D. Rubin, MD, MBA, and Bhavik N. Patel, MD, MBA, of the Duke University School of Medicine in Durham, NC, discuss the financial drivers that healthcare organizations base investment decisions on and the central role that stochastic financial modeling should play in support of strategically aligned capital investments.

    Stochastic modeling through Monte Carlo simulation is a readily accessible and mastered technique that accommodates uncertainties and provides unique insights to inform and refine decision making.

    “Radiologists will benefit immeasurably by learning the basics of financial modeling, but building robust models and executing statistically supported forecasts is a skill that will likely be implemented by business managers or analysts. Regardless, radiologists bring unique insights to decisions and thus should not delegate the responsibility of scrutinizing the quality and validity of a financial model’s structure, including its inputs, assumptions, and interrelationships,” the authors write.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available online only.

    Radiologic-Pathologic Correlation of Primary and Secondary Cardiomyopathies: MR Imaging and Histopathologic Findings in Hearts from Autopsy and Transplantation

    Areas of late gadolinium enhancement (LGE) in cardiomyopathies correspond to histopathologic findings of interstitial expansion, such as fibrosis, abnormal protein deposition, infiltration of inflammatory cells, necrosis of cardiomyocytes, and granulomas. However, correlating histopathologic and cardiac MRI findings — those of diffuse myocardial disease in particular — is sometimes difficult.'

    In the May-June issue of RadioGraphics, (RSNA.org/RadioGraphics), Hiromi Hashimura, MD, PhD, of the National Cerebral and Cardiovascular Center in Osaka, Japan, and colleagues describe the cardiac MRI findings of cardiomyopathies assessed in whole-heart autopsy or transplantation specimens from individuals with various primary or secondary cardiomyopathies, with a focus on LGE imaging.

    The authors also review the histopathologic findings that correspond to areas with and without LGE, and the current T1 mapping techniques used to overcome the drawbacks of LGE imaging, including quantification of native T1 values and the extracellular volume fraction.

    LGE MRI cannot depict the diffuse changes and does not enable quantitative evaluation of the increased interstitial space because on inversion-recovery MR images, the inversion time is adjusted to null the signal from normal-appearing or the least enhancing regions of the myocardium.

    “Thus, the absence of LGE does not always indicate normal myocardial tissue,” the authors write.

    This article is accompanied by an Invited Commentary by Jonathan D. Dodd, MD, of St. Vincent’s University Hospital and University College Dublin School of Medicine in Ireland, and David J. Murphy, MD, of Brigham and Women’s Hospital, Boston.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available online only.

    Radiology Podcasts

    Radiology Podcasts
    Radiology Podcasts

    Listen to Radiology Editor Herbert Y. Kressel, MD, deputy editors and authors discuss the following articles in the February issue of Radiology at RSNA.org/Radiology-Podcasts.

    • “Impact of in Vivo High-Field-Strength and Ultra-High-Field-Strength MR Imaging on DNA Double-Strand-Break Formation in Human Lymphocytes,” Annika Reddig, MS, and colleagues.
    • “Is There Long-term Signal Intensity Increase in the Central Nervous System on T1-weighted Images after MR Imaging with the Hepatospecific Contrast Agent Gadoxetic Acid? A Cross-sectional Study in 91 Patients,” Johannes Kahn, MD, and colleagues.
    • “No Signal Intensity Increase in the Dentate Nucleus on Unenhanced T1-weighted MR Images after More than 20 Serial
      Injections of Macrocyclic Gadolinium-based Contrast Agents,” Alexander Radbruch, MD, and colleagues.
    • “Clearance of Gadolinium from the Brain with No Pathologic Effect after Repeated Administration of Gadodiamide in Healthy Rats: An Analytical and Histologic Study,” Adrian P. L. Smith, PhD, and colleagues.

    RadioGraphics Podcasts

    Radiology Podcasts

    Listen to RadioGraphics Editor Jeffrey S. Klein, MD, and authors discuss the following article in the April-May issue of RadioGraphics at pubs.RSNA.org/Page/RadioGraphics/Views.

    • “Contrast-enhanced US–guided Interventions: Improving Success Rate and Avoiding Complications Using US Contrast Agents” by Dean Y. Huang, FRCR, EBIR, and colleagues.



    Cardiac MRI findings and measurements in a patient with hypertrophic cardiomyopathy. (a) Short-axis late gadolinium enhancement (LGE) MRI shows patchy areas of LGE from the interventricular septum to the anterior wall at the midventricular level. (b, c) On the corresponding extracellular volume (ECV) (b) and native T1 (c) maps, the ECV (47 % circle 1 in b) is markedly increased and the native T1 (1415 msec, circle 1 in c) is moderately elongated in the area with LGE. In the corresponding area without LGE in the interventricular septum, the ECV (31 %, circle 2 in b) is slightly increased and the native T1 (1280 msec, circle 2 in c) appears to be minimally elongated. (RadioGraphics 2017;37;3:719-736) © RSNA 2017. All rights reserved. Printed with permission.