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  • Journal Highlights

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

    June 1, 2017

    Hematogenous Osteomyelitis in Infants and Children: Imaging of a Changing Disease

    The clinical and radiologic presentation of acute hematogenous osteomyelitis in children has changed substantially over the past two decades. The disease is now more common, more destructive and more likely to be associated with complications.

    In the June issue of Radiology (RSNA.org/Radiology), Diego Jaramillo, MD, MPH, from Children’s Hospital of Philadelphia, and colleagues provide an overview of the imaging implications for hematogenous osteomyelitis directed by the changing epidemiology, the newer insights of anatomy and pathophysiology, the imaging characteristics with emphasis on specific locations and disease complications, and the differential diagnosis considerations.

    The researchers conclude that the imaging approach to acute hematogenous osteomyelitis in children has to be directed not just to the detection of the primary focus of infection, but also to the evaluation for collections of pus in the subperiosteal space, soft tissues and joints.

    “As it has become clear that more prompt and better-targeted therapy leads to better outcomes, pharmacological and surgical therapies also have been modified. Given the changes in clinical manifestations and management, we must adjust the imaging approach to the disease,” the authors write.

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

    Chemoembolization of Hepatocellular Carcinoma with Extrahepatic Collateral Blood Supply: Anatomic and Technical Considerations

    Transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) through hepatic and extrahepatic collateral (EHC) arteries is essential for achieving optimal therapeutic outcomes. However, determining the presence of EHC arteries is sometimes challenging.

    In the May-June issue of RadioGraphics, (RSNA.org/RadioGraphics), Amr Soliman Moustafa, MD, PhD, of the University of Arkansas for Medical Science in Little Rock and Zagazig University in Egypt, and colleagues review the factors influencing the development of an EHC arterial blood supply to HCC.

    They also describe a systematic approach to enhance the ability to predict the presence of EHC arteries. In addition, they describe the proper technique for TACE of each EHC artery and how to avoid potential technique-related complications.

    “Performing a combination of conventional CT, cone-beam CT, and angiography is essential for identifying any potential EHC arterial supply to adequately embolize the tumor for a maximal therapeutic effect. To prevent any technique-related adverse effects, TACE through EHC arteries should be performed by those who have a good understanding of the vascular anatomy,” the authors write.

    This article has an Invited Commentary by Douglas M. Coldwell, PhD, MD, Department of Radiology, University of Louisville Hospital, KY.

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

    Deadline Nears to Nominate Radiology Articles for the 2017 Margulis Award

    Deadline for Nominations June 10

    The Nominating Committee for the Alexander R. Margulis Award for Scientific Excellence is accepting nominations from readers for Radiology articles published between July 2016 and June 2017. The main selection criteria are scientific quality and originality. Please send your nomination, including the article citation and a brief note highlighting the reasons for nomination, to Pamela Lepkowski, assistant to the editor, plepkowski@rsna.org.

    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.

    A round-table discussion about gender issues in radiology:

    • “Gender Issues Persist in Academic Radiology Promotions,” Christine M. Glastonbury, MBBS, Susan D. Wall, MD, and Ronald L. Arenson, MD.
    • “Gender Differences in Academic Rank of Radiologists in U.S. Medical Schools,” Neena Kapoor, MD, and colleagues.

    A round-table discussion about digital mammography benchmarks:

    • “2017 Breast Cancer Surveillance Consortium Reports on Interpretive Performance at Screening and Diagnostic Mammography: Welcome New Data, But Not as Benchmarks for Practice,” Carl J. D’Orsi, MD, and Edward A. Sickles, MD.
    • “National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium,” Constance D. Lehman, MD, PhD, and colleagues.
    • “National Performance Benchmarks for Modern Diagnostic Digital Mammography: Update from the Breast Cancer Surveillance Consortium,” Brian L. Sprague, PhD, and colleagues.


    MR image in a one-month-old boy with fever and inability to move the lower extremity. Sagittal non–fat-suppressed T1-weighted image obtained after intravenous administration of gadolinium-based contrast agent shows an area of enhancement in the proximal tibia (black arrow) that extends to the epiphysis. There is also an area of nonenhancement (white arrow) in the calf with an enhanced rim, consistent with a soft tissue abscess. (Radiology 2017;283;3:629-643) © RSNA 2017. All rights reserved. Printed with permission.

    Recurrent HCC supplied by the right renal artery in a 68-year-old man with a history of liver transplantation complicated by a hepatic artery aneurysm, for which surgical repair was required. (a) Right renal artery angiogram shows multiple tortuous feeders (arrows) originating from the right renal artery proximal to the renal hilum and supplying a hypervascular HCC (*) in the dome of the right hepatic lobe. (b) Angiogram shows that subselective catheterization and TACE of one of the feeders were performed without complications. (RadioGraphics 2017; 37;3:963–977) © RSNA 2017. All rights reserved. Printed with permission.