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  • Journal Highlights

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

    August 1, 2017

    Advanced Renal Cell Carcinoma: Role of the Radiologist in the Era of Precision Medicine

    For the last decade, advanced renal cell carcinoma (RCC) has been at the forefront of oncologic innovation. While there is extensive imaging research on RCC, the important themes that could shape the future of RCC imaging revolve around the use of imaging as a biomarker to predict the make-up and behavior of the disease.

    In an article published online in Radiology(RSNA.org/Radiology), Atul B. Shinagare, MD, of the Dana-Farber Cancer Institute, Boston, and colleagues review developments in management of advanced RCC from a radiologist’s perspective with the aim of enhancing the specialty’s value in clinical management. Specifically, the authors describe:

    • How the underlying molecular mechanisms of RCC provide specific targets for novel anticancer agents

    • The relationship between the mechanisms of action of the novel anticancer agents and the imaging appearance of tumor response

    • Available tumor response criteria and their strengths and weaknesses

    The authors also summarize the class- and drug-specific toxicities and complications associated with the novel anticancer agents and discuss the potential role of radiogenomics and texture analysis in the management of advanced RCC.

    “State-of-the-art knowledge of the molecular basis of RCC, novel targeted therapies used for treatment of RCC and their response patterns and toxicities is essential in order for the radiologist to have an effective dialogue with referring physicians and remain relevant in the care of patients with advanced RCC,” the authors write.

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

    An Interventionist’s Guide to Endocrine Consultations

    Endocrinopathies are a heterogeneous group of disorders with complex and changing diagnostic and treatment algorithms. When the clinical scenario, laboratory testing and noninvasive imaging fail to aid confident identification of the source of hormone excess, endocrine venous sampling may localize obscure lesions to guide subsequent treatment.

    In an article in the July-August issue of RadioGraphics, (RSNA.org/RadioGraphics), Eric J. Monroe, MD, of Seattle Children’s Hospital, and colleagues offer a practical guide for interventional radiologists to confidently field endocrine consultations and successfully perform endocrine venous sampling procedures. The authors also present a review of sampling techniques, results interpretation and acknowledgment of limitations in an organ-based approach.

    A successful endocrine venous sampling program demands a collaboration among interventional radiology, surgical and medical subspecialists centered around an individual patient, according to the authors.

    “Success in the angiography suite requires familiarity with normal and variant anatomy of the multiple organs of the endocrine system, patient preparation, stimulation and sampling techniques, specimen handling, and results interpretation,” the authors write.

    The article has an Invited Commentary by Anil K. Pillai, MD, and Alan Cohen, MD, Department of Diagnostic and Interventional Imaging, University of Texas Medical School at Houston, Texas.


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

    Radiology Podcasts

    Radiology Podcasts 

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

    The first podcast is a roundtable discussion with the authors of these articles:

    • “The Effect of Iodine-based Contrast Material on Radiation Dose at CT: It’s Complicated,” John M. Boone, PhD, and Andrew M. Hernandez, PhD.
    • “The Effect of Contrast Material on Radiation Dose at CT: Part I. Incorporation of Contrast Material Dynamics in Anthropomorphic Phantoms,” Pooyan Sahbaee, PhD, W. Paul Segars, PhD, Daniele Marin, MD, Rendon C. Nelson, MD, and Ehsan Samei, PhD..
    • “The Effect of Contrast Medium on Radiation Dose in CT: Part II. A Systematic Evaluation across 58 Patient Models,” Pooyan Sahbaee, PhD, Ehsan Abadi, MS, W. Paul Segars, PhD, Daniele Marin, MD, Rendon C. Nelson, MD, and Ehsan Samei, PhD.
    • The second podcast features the study:

    • “MR Imaging for Diagnosis of Malignancy in Mammographic Microcalcifications: A Systematic Review and Meta-Analysis,” Barbara Bennani-Baiti, MD, and Pascal A. Baltzer, MD.

    RadioGraphics Podcasts

    Radiology Podcasts

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

    • “Imaging of Pregnancy-related Vascular Complications,” R. Scooter Plowman, MD, MBA, MHSA, and colleagues.

    Important intracellular pathways and targets for novel anticancer agents in renal cell carcinoma (RCC). VHL = von Hippel-Lindau, HIF-α = hypoxia-induced factor, VEGF = vascular endothelial growth factor, VEGFR = vascular endothelial growth factor receptor, GFs = growth factors, GFR = growth factor receptors, PI3 K = phosphatidyl-inositol-3 kinase, mTOR = mammalian target of rapamycin, PD = programmed death receptor. (Radiology 2017;284;2:InPress) © RSNA 2017. All rights reserved. Printed with permission.

    Selective parathyroid venography in a 68-year-old woman with recurrent hyperparathyroidism after surgery. Digital subtraction venogram with catheter in the left thymic vein demonstrates a prominent left inferior thyroid vein. Parathyroid venous sampling demonstrated a parathyroid hormone (PTH) level of 2609 pg/dL from the left inferior thyroid vein. The PTH levels of the remainder of the sampled veins ranged from 68 to 174 pg/dL. Pathologic analysis after focused surgery revealed a single missed parathyroid adenoma. (RadioGraphics 2017;37;4:1246–1267) © RSNA 2017. All rights reserved. Printed with permission.