Radiology Launches "Hear What We Think" Podcasts
Radiology Editor Herbert Y. Kressel, M.D., has launched a new podcast feature, "Hear What We Think," providing additional insights into selected journal articles from Radiology. Each Radiology issue will have a podcast and archive will be maintained on the Web site. To stream or download the latest podcast, visit Radiology online and click the "Hear What We Think" link.
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Leading the News
FDA Issues Public Health Advisory Regarding Topical Anesthetics
The FDA has issued a public health advisory focused specifically for radiologists, emergency room healthcare professionals, and risk managers regarding the safety of topical anesthetics used to prevent pain during mammography as well as other medical tests and conditions. The advisory was issued following reports received by the agency that these products may be associated with serious adverse events including irregular heartbeat, seizures, breathing problems, and possibly even death when applied over a large area of skin or when the area of application is covered.
From "Topical Anesthetics"
Medwatch (01/16/2009)
Research
Radiation Lowers Relapse Risk in Noninvasive Breast Cancer
A new meta-analysis, conducted by University of Sydney researchers led by Dr. Annabel Goodwin, has found that the combination of radiation therapy and lumpectomy can significantly decrease the risk of recurrence in patients with ductal carcinoma in situ (DCIS). The research, which appears in Cochrane Library, compares outcomes in 3,925 women with DCIS who underwent lumpectomy either with or without radiation therapy. Following a review of this data, Dr. Goodwin and her team found that the addition of radiation therapy following lumpectomy decreases the risk of recurrence of either DCIS or invasive breast cancer by 51 percent.
From "Radiation Lowers Relapse Risk in Noninvasive Breast Cancer"
eMaxHealth.com (01/21/09)
RECIST Guidelines Updated
The Response Evaluation Criteria in Solid Tumors (RECIST) guidelines have recently been updated in order to make it easier for radiologists to determine tumor changes during a clinical trial without compromising study outcomes. The new version of the RECIST guidelines, published in the European Journal of Cancer, were developed by National Cancer Institute of Cancer Prof. Elizabeth Eisenhauer and her team. Key changes to the guidelines include a reduction in the number of lesions to be assessed for treatment response, new guidance to detect lymph node involvement, a change in the definition of disease progression to include a 20 percent increase in the size of the lesion as well as a 5 mm absolute increase in tumor size, a new requirement that mandates all trials with objective response as their primary endpoint confirm response to treatment, and new imaging guidance that details the use of imaging in the detection of new lesions and the interpretation of FDG-PET scan assessment.
From "New Criteria for Measuring Tumor Size and Progression Will Help Ease Workloads in Clinical Trials"
ScienceDaily (01/20/09)
Researchers Seek to Map Brain Patterns of Alzheimer's Disease
UC Davis Prof. Owen Carmichael and his team are currently conducting research to determine if MRI can be used to detect Alzheimer's disease before patients begin to show symptoms of cognitive decline. Additionally, they hope to use MRI to predict the rate at which the brains of patients with Alzheimer's deteriorate compared to patients without the disease. To achieve these goals, Dr. Carmichael and his team have developed a computational method of measuring atrophy in sub-regions of the hippocampus in an attempt to determine whether Alzheimer's produced different patterns of hippocampal atrophy that would distinguish it from atrophy normal in the aging process.
From "UC Davis Researchers Seek to Map Brain Patterns of Alzheimer's Disease"
Genetic Engineering News (01/16/09)
Technology
Method Developed to Estimate Tumor Characteristics Using CBCT Projections
Stanford researchers led by Per Rugaard Poulsen have developed a probability-based method designed to estimate the mean position, motion magnitude, and trajectory of tumors using cone-beam CT (CBCT) projections. The new method is based on the assumption that the target position of a tumor can be detected using a 3D Gaussian distribution, which can be estimated using a series of projection images. To determine the accuracy of the proposed method, the researchers conducted a simulation study based on 80 hours of patient-measured trajectories for thoracic/abdominal and prostate tumors. These trajectories were divided into 60-second segments. Then, researchers used the segments to simulate CBCT by projecting the tumor position onto a rotating integer.
From "A Method to Estimate Mean Position, Motion Magnitude, Motion Correlation, and Trajectory of a Tumor From Cone-Beam CT Projections for Image-Guided…"
Stanford University (01/25/09) Poulsen, PR; Cho, B; Keall, PJ
BHF Supports the Use of MRI Following Myocardial Infarction
The British Heart Foundation (BHF) has officially endorsed the use of MRI to image damage and bleeding following a myocardial infarction. BHF representatives have said the use of MRI under these circumstances may help prevent unnecessary surgery in many cardiac patients and could help healthcare professionals better understand damage done to the heart and surrounding structures during a myocardial infarction. The BHF's support is based on the study, "Reperfusion Hemorrhage Following Acute Myocardial Infarction: Assessment With T2 Mapping and Effect on Measuring the Area at Risk," which was partially funded by the foundation. The study, led by Dr. Declan O'Regan of the Imperial College of London, was recently published in the journal Radiology and reported in last week's issue of RSNA.
From "New Scan Could Tell the Story Behind Heart Attacks, Says BHF"
British Heart Foundation (01/19/2009)
Early Warning Detector for MRI Launched
A new type of metal detection system designed for MRI scanning suites has been developed to prevent adverse events associated with the presence of ferrous metals in the MRI suite. According to a recent study, such events occur in one out of every 1,000 MRI scans. To mitigate this risk, the American College of Radiologists recommend that such warning systems be used during all MRI scans.
From "Making MRI Scanning Safer: Early Warning Metal Detector Launches"
Medical News Today (01/14/09)
Medical-Legal Issues
Legal Considerations Emerge as CT Scans Increase
The number of CT scans performed in the United States has increased more than 20 fold over the last quarter century, according to a recent study published in the New England Journal of Medicine. A similar study in the journal also found that increasing radiation exposure associated with the growing number of CT scans could be responsible for as many as 2 percent of all cancers in the United States during the next 20 to 30 years. In light of these and similar statistics, legal experts argue that radiologists and device manufacturers could soon be exposed to significant liability risks associated with radiation exposure due to CT scanning. They have identified two possible types of risk that could result in litigation. The first is a design defect risk, which could result in a suit if the plaintiff can prove that the device maker or healthcare professional created or used a device that did not expose the patient to as little radiation as possible. The second type of risk is known as failure to warn. These risks could result in litigation if the plaintiff is able to prove that their healthcare provider did not adequately warn them of the risks associated with CT scanning.
From "CT Scans and Radiation Exposure: Emerging Legal Considerations for Imaging Manufacturers"
Medical Device Link (01/01/09) Rysavy, Charles F.; Shaw, Roger P.
Clinical Practice
Digital Mammograms May Take Longer to Interpret
According to a recent study led by University of Texas Prof. Tamara Miner Haygood, digital mammograms may take more time to interpret than traditional film-screen mammograms. Results of the study, found in the American Journal of Roentgenology, showed that it took radiologists an average of four minutes to read digital screening mammograms compared to film-screen mammograms, which took only an average of two minutes, seven seconds to interpret.
From "Interpretation Time for Screening Digital Mammograms: Is it Efficient?"
Newswise (01/06/09)
Technology Used Wrongly Harms Patients, Joint Commission Warns
The Joint Commission issued an alert warning healthcare groups that technology used wrongly can lead to medical errors. U.S. Pharmacopeia's Medmarx voluntary drug error-reporting database shows at least 10 percent of all harmful medication mistakes are the result of a technology failure such as barcodes that do not scan properly. The alert advised hospitals to include physicians and other health professionals in the implementation of new technology instead of relying solely on vendors. New technology can have unintended consequences such as removing an established safety check. The Joint Commission previously warned healthcare providers about potential problems with specific technology such as infusion pumps and MRI machines.
From "Technology Used Wrongly Harms Patients, Joint Commission Warns"
American Medical News (01/15/09) O'Reilly, Kevin B.
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