Venograms (anteroposterior views) show chronic phlebitic changes in calf veins characterized by absence of valves, linear synechiae and focal strictures or occlusions. Normally, numerous valves are found in calf veins, but they are absent here. (a) Venogram obtained with left foot vein injection shows atretic posterior tibial vein (white arrows) and focal strictures in peroneal vein (black arrows). A long atretic segment of the lesser saphenous vein (unmarked) can also be visualized. Retrograde popliteal injection venograms of a right leg (b) and left leg (c) show absence of valves, linear synechiae (white arrows) and focal strictures (black arrows). Absence of valves allows retrograde-injected contrast material to reflux down almost to ankle.

(Radiology 2008;246:619–629) © RSNA, 2008. All rights reserved. Printed with permission.

Alteplase injection can reduce the risk of pulmonary embolism in patients with deep-vein thrombosis (DVT), a clinical study has shown.

In a study of 13 men and seven women with first-onset acute DVT, Richard Chang, M.D., of the Department of Diagnostic Radiology at the Warren G. Magnuson Clinical Center of the National Institutes of Health, and colleagues evaluated daily intraclot injection or "lacing" with alteplase along with systemic anticoagulation as an alternative to continuous-infusion thrombolytic regimens.

After six months of anticoagulation therapy, antegrade blood flow was restored in 80 percent of the patients and 90 percent of patients experienced complete resolution of symptoms. Ventilation-perfusion scans showed a 40 percent incidence of pulmonary embolism before therapy and a 15 percent incidence of asymptomatic pulmonary embolism during therapy. "During a mean follow-up period of 3.4 years, no patient developed a postthrombic syndrome or recurrent thromboembolism," the researchers note. Recovery of plasminogen activator inhibitor-1 levels and rapid clearance of circulating alteplase were observed within 2 hours after completion of treatment.

"Intraclot injection or lacing of the thrombus with a fibrin-binding thrombolytic agent such as alteplase is an alternative to continuous-infusion regimens and minimizes the duration of systemic exposure to thrombolytic agents," the authors conclude.

Diagnostic Accuracy of Digital versus Film Mammography: Exploratory Analysis of Selected Population Subgroups in DMIST

Digital mammography detects cancer better than film mammography in pre- and perimenopausal women aged 50 or younger with dense breasts, a multicenter study has revealed.

A retrospective analysis of the American College of Radiology Imaging Network’s Digital Mammographic Imaging Screening Trial (DMIST) compared digital and film mammography in overlapping groups of women categorized by age, menopausal status and breast density. The study involved 33 centers and 42,760 women.

Etta D. Pisano, M.D., of the Departments of Radiology and Biomedical Engineering at the UNC-Lineberger Comprehensive Cancer Center and the Biomedical Research Imaging Center of the University of North Carolina School of Medicine, and colleagues found that the area under the receiver operating characteristic curve for digital mammography was 79 percent, versus 54 percent for film mammography, in the combined groups of women with dense breasts, pre- and perimenopausal women and women aged 50 years or younger.

For women aged 65 years or older with fatty breasts, film performed slightly better than digital mammography, the researchers found.

Dr. Pisano and colleagues assert that, because the results of the original DMIST analysis were not anticipated, "the originally planned analysis did not attempt to dissect the effect of the three different factors combining the groups for which digital mammography performed better."

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Media Coverage of RSNA 2007

More than 2,000 stories about RSNA 2007 have been carried by print, broadcast and online media. Notable print placements include The New York Times, USA Today, Los Angeles Times, Chicago Tribune, Newsday, New York Post, Boston Globe, Philadelphia Inquirer, Scientific American, The Times (London) and National Post (Canada).

Thirteen news conferences were held during RSNA 2007. Broadcast coverage included stories televised nationally and internationally on CBS, NBC, ABC, FOX, CNN, CNN Headline News, Fox News Channel, CW Superstation, Univision and the Canadian networks CBC and CTV. Programs featuring news conference topics or taping onsite at RSNA 2007 included CBS Evening News, NBC Nightly News, ABC World News Tonight, Fox and Friends, American Morning (CNN) and Up to the Minute (CBS). In addition, radio coverage included multiple placements on Voice of America, ABC Radio Network, CBS Radio Network, National Public Radio and CNN Radio.

Prominent Web coverage included The Wall Street Journal and The New York Times online editions and WebMD.

February Public Information Activities Focus on the Heart

To highlight Heart Health Awareness Month in February, RSNA will distribute public service announcements (PSAs) focusing on new imaging tools available to diagnose heart and vascular diseases in their early stages.

In addition to the PSAs, RSNA will distribute the "60-Second Checkup" radio program focusing on heart health-related imaging technologies such as cardiovascular MR and coronary CT angiography to detect coronary artery disease.