Computer screen shows patient database results. BUA = broadband ultrasound attenuation (in decibels per megahertz), SOS = speed of sound.
(Radiology 2008;248:179–184) © RSNA, 2008. All rights reserved. Printed with permission.

A prediction rule using bone ultrasound and four clinical risk factors can identify women at risk for osteoporotic fracture.

Idris Guessous, M.D., of the Lausanne University Hospital in Switzerland, and colleagues assessed multiple risk factors in addition to stiffness index (SI) as determined by quantitative heel ultrasound to calculate the likelihood of fracture in 6,174 women aged 70 to 85 years. When evaluated against subsequent fractures, the resulting scores predicted risk with 90 percent sensitivity.

Significantly predictive factors were age greater than 75 years, low heel SI, history of fracture, recent fall and inability to rise from a chair three times in succession without using arms for support. A low SI indicated a fourfold increase in fracture risk.

"Integration of heel quantitative ultrasound parameters may be an effective alternative to dual-photon X-ray absorptiometry in responding to the expected growth in demand for osteoporosis management in the next decades," the researchers write.

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Estimating Long-Term Effectiveness of Lung Cancer Screening in the Mayo CT Screening Study

Base-case stage shift.
Model-predicted lung cancer cases (per 1,000 participants) detected in the first five years after simulated randomization, stratified according to trial arm. Compared with nonscreening cohort, screening yields a higher number of non-small-cell lung cancers (NSCLCs), a greater proportion of which are stage I. Also predicted is a stage shift from stage IV NSCLC to earlier stages. No comparable increase in cases of small-cell lung cancers (SCLCs) was predicted and the distribution of limited stage (LS) versus extensive stage (ES) was not significantly changed with screening.
(Radiology 2008;248:278–287) © RSNA, 2008. All rights reserved. Printed with permission.

Helical CT screening for lung cancer may offer a moderate reduction in lung cancer mortality in a population of heavy smokers.

Pamela M. McMahon, Ph.D., of the Institute for Technology Assessment at Massachusetts General Hospital in Boston, and colleagues examined helical CT images and outcomes in 1,520 current or former smokers aged 50 to 85 and developed a prediction model for lung cancer and deaths in a population that received five annual screenings versus one that received no screening. "Single-arm studies cannot demonstrate that lung cancer screening with CT will reduce cancer-specific or overall mortality rates," the researchers write. "We simulated outcomes for the screened arm of a recent single-arm study and a hypothetical control (unscreened) arm to estimate screening effectiveness in the study cohort."

The screened population demonstrated a 37 percent increase in lung cancer detection at six years follow-up and a 9 percent increase at 15 years. Lung cancer-specific mortality was reduced by 28 percent at six years and 15 percent at 15 years, while the relative reduction in mortality from all causes was 4 percent at six years and 2 percent at 15 years. "Screening may reduce lung cancer-specific mortality but offer a smaller reduction in overall mortality due to increased competing mortality risks associated with smoking," the researchers concluded.

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Discrimination between Alzheimer Disease, Mild Cognitive Impairment and Normal Aging by Using Automated Segmentation of the Hippocampus

MR images show automated hippocampal segmentation.
(a) Coronal and sagittal reconstructions of patient with Alzheimer disease. (b) Coronal and sagittal reconstructions of healthy elderly control. T1-weighted MR images acquired by using spoiled gradient-echo sequence (128 adjacent transverse sections parallel to anterior commissure-posterior commissure line; section thickness, 1.5 mm; pixel size, 0.9375 x 0.9375 mm; 10.3/2.1; field of view, 24 x 18 cm; and matrix, 256 x 192).

A method that automatically segments the hippocampus on MR imaging may aid in the diagnosis of Alzheimer disease (AD).

In a study of 74 patients, Olivier Colliot, Ph.D., of the Cognitive Neuroscience and Brain Imaging Laboratory at the Hôpital de La Salpêtrière in Paris, and colleagues found that automated classification based on hippocampal volume distinguished patients with AD or amnestic mild cognitive impairment (MCI) from healthy elderly controls.

The method showed 84 percent accuracy for distinguishing patients with AD from controls and 73 percent accuracy for distinguishing patients with MCI from controls. Significant reduction in hippocampal volume was found both in patients with AD and those with MCI. Accuracy for distinguishing AD from MCI was 69 percent.

"Our automated method can serve as an alternative to manual tracing and may thus prove useful in assisting the diagnosis of AD," the researchers write.

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Media Coverage of Radiology

In May, media outlets carried 182 news stories generated by articles appearing in Radiology. These stories reached an estimated 123 million people.

Print coverage included the Lexington Herald-Leader (Lexington, Ky.), News & Observer (Raleigh, N.C.), The Star-Ledger (Newark, N.J.), The Day (New London, Conn.), Modesto Bee (Fresno, Calif.), The Ledger (Lakeland, Fla.), Tuscaloosa News (Tuscaloosa, Ala.) and Gadsden Times (Gadsden, Ala.).

Web placements included AOL.com, Yahoo! News, Forbes.com, MSN.com, iVillage.com and Medscape.com.

July Public Information Activities Highlight Neuroradiology

In July, RSNA's "60-Second Check-up" radio segments focused on neuroradiology, including:

• Early indications of Alzheimer disease

• Detection of attention deficit hyperactivity disorder and Alzheimer disease using MR imaging

• The link between depression and Alzheimer disease

• The radiologist's role in diagnosing and treating dementia