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From RSNA
January RSNA News Now Online
The full version of the January issue of RSNA News is now available online.
Highlights include:
MR Predicts Cardiac Ablation Success
A recent study shows that MR imaging to measure scarring to the left atrium following radiofrequency ablation (RFA) for the growing problem of atrial fibrillation can predict treatment success.
Radiologists Prepare for Radiation Terrorism
A group of scientific experts is striving to prepare the medical community for a possible radiation terrorism event by offering a course that answers all their questions.
International e-Health Initiatives Vary in Execution, Effectiveness
Although e-health initiatives will have a major impact on 21st century medicine, some leaders at RSNA's International Trends meeting 2008 spoke of slow progress toward teleradiology and the electronic medical record (EMR).
RSNA 2008 in Pictures
Exciting technological advancements and expert collaboration drove new programs and enhancements to longstanding favorites at the 94th RSNA annual meeting.
In 10th Year, Online Journals Stay on Technology's Edge
In 2009, as Radiology and RadioGraphics celebrate their 10th anniversary of online publication, the journals offer extensive access to timely and relevant information--in ways the editors envisioned and in others they may never have imagined.
Leading the News
Tiny Chemo Beads Boost Liver Cancer Outcomes
Several new studies have concluded that a cancer treatment therapy known as transarterial chemoembolization (TACE) is capable of stopping liver tumors from spreading to other parts of the body. In the first of these studies, which took place at St. Joseph's Hospital and Medical Center in Tampa, Fla., 11 liver cancer patients were given the treatment, in which microspheres or beads are used to block the blood vessels feeding the tumor and cut off its blood supply. In addition to cutting off the tumor's blood supply, the beads contain chemotherapeutic agents that attack the cancer. Of the liver cancer patients that received this treatment, 10 were still alive two years later. Most liver cancer patients die two years after being diagnosed. In addition, the treatment was given to 13 people who had colorectal cancer that had spread to their livers. Of those patients, 10 were still alive two years after receiving the treatment. Glenn Stambo, a vascular and interventional radiologist at St. Joseph's, said that TACE was the most successful in patients whose tumors and blood vessel feeders were isolated. The study, along with the two others done on TACE, show that the technique holds promise in treating liver cancer, which is often difficult to eradicate. Patients with liver cancer often cannot have their tumors surgically removed, due to the size and location of the tumors or the fact that the tumor has grown into the blood vessels. TACE also holds promise because it delivers chemotherapy directly to the tumor instead of the whole body.
From "Tiny Chemo Beads Boost Liver Cancer Outcomes"
HealthDay (01/20/09)
Research
Protocol Changes Can Reduce Radiation Exposure During Voiding Cystourethrography
Researchers, led by Dr. Valerie L. Ward, compared radiation-exposure levels in 175 children between three days and eight years old who were treated with voiding cystourethrography (VCUG) performed with grid-controlled variable-rate pulsed fluoroscopy (GCPFL) or VCUG performed with continuous fluoroscopy (CFL). The scientists found that children treated with VCUG performed with GCPFL were exposed to eight times less radiation than those treated with VCUG performed with CFL.
From "Pediatric Radiation Exposure and Effective Dose Reduction During Voiding Cystourethrography"
Medical News Today (01/14/09)
MRI May Gauge Heart Attack Risk
Physicians may soon be able to use MRI scans to identify patients at risk of a heart attack. Simon Robinson, of Lantheus Medical Imaging, and colleagues have attached gadolinium chelate, already used to light up blood in MRI scans, to a molecule that binds to the protein elastin in artery walls. Using pigs for their experiment, the researchers found that the molecule binds to the elastin and lights up the artery walls in an MRI scan. This could image the arteries of people who are at risk of a heart attack, showing thickening that suggests the presence of plaques. If plaques are found, patients could be given cholesterol-lowering drugs or fitted with a stent. The contrast agent is under safety trial with Lantheus, which hopes to test humans in early 2010, though the gadolinium-based contrast agent may be linked to kidney problems.
From "MRI Scan to Gauge Heart Attack Risk"
New Scientist (01/10/09) P. 10; Geddes, Linda
Imaging Combo Increases Prostate Cancer Detection
T2-weighted MRI images combined with the apparent diffusion coefficient map improve prostate cancer detection over T2 images alone, researchers report. Hyun Kyung Lim, MD, of the University of Ulsan in Seoul, South Korea, and colleagues performed a retrospective study of 52 patients who had undergone endorectal MRI and step-section histologic examination. Independent readers reviewed T2-weighted images alone, the apparent diffusion coefficient map alone, and a combination of T2-weighted images and the apparent diffusion coefficient map. The researchers made comparisons by calculating the areas under the receiver operating characteristic curve (AUC). For each of the three readers, the combination's AUC , sensitivity (78 to 88 percent), and accuracy (68 to 88 percent) were all higher than the AUC, sensitivity, and accuracy of the T2 images alone. The report was published in the January issue of Radiology.
From "Imaging Combo Increases Prostate Cancer Detection"
Modern Medicine (12/29/08)
Technology
New Agent Improves MR Scanning of Tumors
A new MRI contrast agent has been developed by TU Delft researcher Kristina Djanashvili. The contrast agent uses a combination of lanthanide chelate and a phenylboronate group substance to improve tumor affinity and contrast induction characteristics.
From "Improved MRI Scanning of Tumors"
News-Medical.Net (01/14/2009)
Novel Technique Changes Lymph Node Biopsy, Reduces Radiation Exposure
Washington University of St. Louis researchers, led by Radiology Professors Lihong Wang and Gene K. Beare, were recently able to use photoacoustic tomography (PAT) to map sentinel lymph nodes (SLN) using gold nanocages. The researchers found that PAT may be able to minimize invasive surgical lymph biopsy procedures to detect metastatic breast cancer and reduce radiotherapy exposure. PAT works using a mix of optical and ultrasonic imaging to create high-resolution images.
From "Novel Technique Changes Lymph Node Biopsy, Reduces Radiation Exposure"
Science Mode (01/14/2009)
Images Captured Inside Heart During Attack
British scientists have for the first time captured images that show bleeding inside the heart after a heart attack. The images should give better insight into tissue damage and subsequent means of treatment, says Dr. Declan O'Regan. Researchers used a new MRI technique to show the damage that heart attacks can cause. The colored area on this MRI scan shows a cross-section of the heart muscle, with the area of bleeding shown in red. Scientists from the MRC Clinical Sciences Centre at Imperial College London hope the imaging will help them identify patients at risk of complications after attacks.
From "Images Taken Inside Heart During Attack"
United Press International (01/19/09)
Lack of Medical Device Interconnectivity Creates Patient Safety Obstacles
In recent years, advances in the area of medical device connectivity has been limited. In particular, experts have noted that one area that needs connectivity is the administration of pain medication. IV pumps have safety features that guard against overdoses but they are usually not connected to the patient's vital signs, so healthcare providers are not notified if the patient experiences a critical event. A task force that includes members from Partners HealthCare, Mass. General, Johns Hopkins Medicine, Kaiser Permanente, and the Boston-based Center for Integration of Medicine and Innovative Technology has created sample language that hospitals can use to require vendors to create interconnective devices. According to FDA biomedical engineer Sandy Weininger, the agency has also been working on the issue of medical device interactivity for several years, with particular focus on patient safety standards.
From "Medical Devices Lag in iPod Age"
Boston Globe (12/29/08) Johnson, Carolyn Y.
Medical-Legal Issues
In FDA Files, Claims of Rush to Approve Devices
Nine FDA scientists have written a letter to the transition team of President-elect Barack Obama voicing concerns that an official at the agency pressured them to approve an experimental mammography device after receiving a phone call from a congressman. This letter follows similar requests for an investigation made by the scientists to the House Committee on Energy and Commerce and to FDA commissioner Andrew C. von Eschenbach. As part of the resulting investigations, medical reviews and emails have been released that show FDA scientists criticizing the agency's review process for medical devices. Representative Christopher Shays (R-Conn.) has identified himself as the congressman whose phone call is referenced in FDA documents. Shays says that he had called the FDA official to encourage the agency to make a final decision regarding the iCAD SecondLook Digital Computer-Aided Detection System for Mammography, which is used with screening equipment made by a company based in the congressman's district. However, Shays denies allegations that he pressured the agency official to approve the device. Whether or not Shay's call had any effect, the FDA scientists still objected to the device's subsequent approval due to concerns that it had never been tested by radiologists under conditions of use included in its application. An internal FDA review found that risks that may be associated with the device include missed cancers, unnecessary biopsy and/or surgery, and unnecessary exposure to radiation.
From "In FDA Files, Claims of Rush to Approve Devices"
New York Times (01/13/09) Harris, Gardiner
Clinical Practice
EHRs May Reduce Medical Liability Risk, Study Shows
Physicians who use electronic health records have fewer medical liability claims and settlements, according to an Archives of Internal Medicine survey of 1,140 Massachusetts doctors. The report, sponsored in part by the Massachusetts eHealth Collaborative and the Agency for Healthcare Research and Quality, found that 6.1 percent of physicians that used EHRs had handled liability claims, compared with nearly 11 percent of physicians who paid claims but relied on paper-based systems. The researchers believe EHR results in fewer diagnostic mistakes, enhances follow-up and patient communication, and fosters better adherence to rules. More stringent documentation of patient medical records through EHR may corroborate a solid defense in the face of a malpractice claim. Additional evidence linking EHRs to reduced risk could lead more medical malpractice insurers to slash their premiums for doctors whose offices rely on the technology, the report states. "Practices with EHRs are going to enjoy a certain level of risk management that practices without [electronic records] aren't going to have," said Physicians Insurance Agency of Massachusetts President Jack King.
From "EHRs May Reduce Medical Liability Risk, Study Shows"
American Medical News (01/15/09) Sorrel, Amy Lynn
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