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Leading the News
Congress Intervenes to Force Continued Nuclear Medicine Funding at DOE
At the urging of nuclear medicine advocates, including the Society of Nuclear Medicine, Congress has instructed the Department of Energy (DOE) to continue funding basic research for radioisotope and imaging instruments design. Congress included language in the fiscal 2009 appropriations act specifically ordering DOE to spend $17.5 million on nuclear medicine applications research. A National Academy of Science blue ribbon panel concluded in 2008 that an earlier elimination of DOE funding led to a substantial loss of support for the basic research that underlies nuclear medicine, and called for its restoration. The Bush administration first attempted to shift funding responsibility for nuclear medicine research from DOE to the National Institutes of Health in 2006. DOE's Office of Biological and Environment Research has been redirecting resources from nuclear medicine programs into biological imaging, but will now be required for at least the next year to fund nuclear imaging as well.
From "Congress Intervenes to Force Continued Nuclear Medicine Funding at DOE"
Diagnostic Imaging (03/27/09) Brice, James
Research
Researchers Develop Automated Algorithm for Quantifying the Extent of Cystic Change on Volumetric Chest CT
Researchers led by Dr. Vincent J. Schmithorst of the Cincinnati Children's Hospital Department of Radiology have developed a new method designed to quantify the severity of cystic lung disease using chest CT. The authors conducted chest CT and pulmonary function testing on 18 patients with lymphangioleiomyomatosis (LAM). A histogram analysis was then designed to compute the cyst volume and the volume of the remaining lung by segmenting the entire lung attenuation histogram into two underlying distributions: one from cysts and one from the remaining lung tissue. This method for quantifying cyst volume as a percentage of total lung volume using chest CT was found to correlate with pulmonary function parameters in patients with LAM, leading researchers to believe the method may be useful in the assessment of disease severity and progression in patients with cystic lung diseases.
From "Automated Algorithm for Quantifying the Extent of Cystic Change on Volumetric Chest CT"
American Journal of Roentgenology (04/01/2009) Vol. 192, No. 4, P. 1037; Schmithorst, Vincent J.; Altes, Talissa A.; Young, Lisa R.
Remodeling Technique Is as Safe as Standard Treatment With Coils for Unruptured Intracranial Aneurysms
Researchers led by Reims University Prof. Laurent Pierot conducted a 547-patient study to determine the safety of a remodeling technique compared to the standard treatment with coils for endovascular treatment of unruptured intracranial aneurysms. They found that the remodeling technique was associated with a similar rate of adverse events and morbidity and mortality combined compared with the standard treatment with coils, leading researchers to conclude that the remodeling technique is as safe as the standard treatment with coils. The full study can be found in Radiology.
From "Endovascular Treatment of Unruptured Intracranial Aneurysms: Comparison of Safety of Remodeling Technique and Standard Treatment With Coils"
Radiology (03/24/09) Pierot, Laurent; Spelle, Laurent; Leclerc, Xavier
MR Colonography May be Enhanced by the Use of Oral PEG-Electrolyte Solution
Oral administration of a polyethylene glycol (PEG)-electrolyte solution yields uniform luminal darkening and sufficient colonic distention for MR colonography in 91 percent to 96 percent of patients, according to a recent study conducted by Istanbul University researchers. The prospective study, published in Radiology, included 55 patients who received between 2.0 L and 2.5 L of PEG-electrolyte solution orally before undergoing MR colonography. Adequate distention of all colonic segments was achieved in 50 to 53 patients imaged in the supine position and 51 to 53 patients imaged in the prone position, the researchers said.
From "MR Colonography After Oral Administration of Polyethylene Glycol-Electrolyte Solution"
Radiology (03/24/09) Bakir, Baris; Acunas, Bulent; Bugra, Dursun
Technology
DTI May Trace Development of Parkinson's Disease
University of Illinois Prof. David Vaillancourt and colleagues have found that diffusion tensor imaging (DTI) may offer an effective method for the diagnosis of Parkinson's disease. Vaillancourt and his team conducted DTI on 28 subjects, half with early symptoms of Parkinson's and half without. DTI allowed researchers to image the loss of dopaminergic neurons in certain areas of the substantia nigra.
From "Imaging Technique May Trace Development of Parkinson's Disease"
Science Daily (03/27/09)
Magnetic Spin to Revolutionize Medical Scanning
University of York researchers have developed a method of transferring magnetic spin to amplify the sensitivity of MR imaging. The new method, published in Science, allows for the magnetization of a wide-range of molecules including drugs and organic compounds. In order to do so, researchers cool the molecule to create parahydrogen, which has a highly ordered magnetic spin state. An iridium catalyst is then use to transfer the magnetic spin from the parahydrogen to other elements. These polarized drugs or marker molecules are then highly visible on MRI scans.
From "Magnetic Spin to Revolutionize Medical Scanning"
Technology Review (03/27/09) Day, Michael
OCT Can Help Distinguish Between Two Causes of Optic Neuritis
Optical coherence tomography (OCT) can help distinguish between two causes of optic neuritis (ON) by measuring retinal nerve fiber layer as a surrogate of axonal injury, according to research conducted by Washington University Prof. Robert T. Naismith. This conclusion is based on a study that included 22 subjects with neuromyelitis optica (NMO) or NMO spectrum disorders and 47 subjects with multiple sclerosis (MS). Naismith and colleagues conducted OCT on all participants, and then used linear mixed modeling to compare the two diagnoses for a given level of vision loss while controlling for age, disease duration, and number of episodes of ON. By doing so, the researchers found that ON within NMO is associated with a thinner overall average retinal nerve fiber layer compared with MS, with particular involvement of the superior and inferior quadrants.
From "Optical Coherence Tomography Differs in Neuromyelitis Optica Compared With Multiple Sclerosis"
Neurology (03/24/2009) Vol. 72, No. 12, P. 1077; Naismith, R.T.; Tutlam, N.T.; Xu, J.
Clinical Practice
Researchers Evaluate the Use of Chemoradiotherapy for Treatment of LAPC
Dr. Florence Huguet of the Assistance Publique-Hopitaux de Paris and colleagues recently conducted a qualitative systematic review of 21 studies to evaluate the role of radiotherapy in patients with locally advanced unresectable but nonmetastatic pancreatic carcinoma (LAPC). They found that while no standard treatment currently exists for LAPC, there are two treatment options for the disease: chemoradiotherapy and gemcitabine-based chemotherapy. Additionally, the researchers found that induction chemotherapy followed by chemoradiotherapy may offer a promising new strategy for selection of patients without early metastatic/progressing disease.
From "Chemoradiotherapy in the Management of Locally Advanced Pancreatic Carcinoma: A Qualitative Systematic Review"
Journal of Clinical Oncology (03/09) Huguet, Florence; Girard, Nicolas; Seblain-El Guerche, Clotilde
Nearly Two Percent of ED Patients Undergoing CT Have High Cumulative Rates of Multiple or Repeat Imaging
Washington University Professor Richard T. Griffey and Dr. Aaron Sodickson of the Brigham and Women's Hospital report that 1.9 percent of emergency department patients undergoing CT of the neck, chest, abdomen, or pelvis have high cumulative rates of multiple or repeat imaging. Collectively, this patient subgroup may have an increased risk of developing cancer from cumulative CT radiation exposure. This conclusion was based on a study of 130 emergency department patients with at least three emergency department visits within a one-year period that included CT of the neck, chest, abdomen, or pelvis. Researchers then identified all diagnostic CT studies for those patients conducted over the previous 7.7 years. The mean number of CT studies was 13, while the maximum was 70 and the median was 10. The authors then calculated the cumulative radiation dose by summing typical effective doses of the anatomic regions scanned. By doing so, they found the average CT dose was 122 mSv. Lifetime attributable risks was then calculated using the population-averaged dose-to-risk conversion factor of one cancer per 1,000 patients receiving a 10-mSv dose. Average risk calculated using this method was one in 82.
From "Cumulative Radiation Exposure and Cancer Risk Estimates in Emergency Department Patients Undergoing Repeat or Multiple CT"
American Journal of Roentgenology (04/01/2009) Vol. 192, No. 4, P. 887; Griffey, Richard T.; Sodickson, Aaron
Reirradiation May Extend Life in Head and Neck Cancers
Lee Moffitt Cancer Center and Research Institute Dr. Tawee Tanvetyanon and colleagues recently found that reirradiation of recurrent head and neck cancer can extend patient life by 59.6 months according to the Charlson index and 44.2 months according to the Adult Comorbidity Evaluation-27 (ACE-27). The study, published in the Journal of Clinical Oncology, included a review of the medical records of 103 patients with head and neck cancer who received reirradiation between 1998 and 2008. Of these patients, Tanvetyanon and colleagues found significant comorbidity in 36 percent using the Charlson index and 24 percent using the ACE-27 index. Organ dysfunction was also found in 37 percent of patients. Patients with both organ dysfunction and comorbidity had median overall survival of 5.5 months according to the Charlson index and 4.9 months according to the ACE-27.
From "Reirradiation May Extend Life in Head and Neck Cancers"
Modern Medicine (03/23/09)
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