Hear What We Think: Listen to Radiology’s Latest Podcasts
This month on Hear What We Think, Radiology editor Herbert Y. Kressel, M.D., moderates author discussions of these articles:
- Alzheimer Disease: Quantitative Structural Neuroimaging for Detection and Prediction of Clinical and Structural Changes in Mild Cognitive Impairment
- Effect of Computerized Order Entry with Integrated Decision Support on the Growth of Outpatient Procedure Volumes: Seven-year Time Series Analysis
- Risks Associated with Low Doses and Low Dose Rates of Ionizing Radiation: Why Linearity May Be (Almost) the Best We Can Do
- The Linear No-Threshold Relationship Is Inconsistent with Radiation Biologic and Experimental Data
Listen now.
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Best Cases from the AFIP
In the latest case from the Armed Forces Institute of Pathology, learn more about the clinical imaging and features of invasive aspergillosis of the central nervous system. This condition is increasingly common due to the growing prevalence of immunosuppression and the increasing length of survival of immunosuppressed patients.
Read more from “Invasive Aspergillosis of the Brain: Radiologic-Pathologic Correlation,” by Badr M. Almutairi, M.D. and colleagues, in the current issue of RadioGraphics.
Leading the News
Two-Phase Cardiac CT Detects Left Atrial Appendage Thrombi in Stroke Patients
Researchers, led by Dr. Jin Hur of the Research Institute of Radiological Science, have found that two-phase 64-section cardiac CT angiography is a noninvasive sensitive modality for detecting left atrial appendage thrombi and differentiating thrombus from circulatory stasis in stroke patients. This conclusion was based on study of 55 patients who had recently experienced a stroke and had high-risk factors for thrombus formation. All study participants underwent both two-phase 64-section cardiac CT angiography and transesophageal echocardiography (TEE). A total of 14 thrombi were detected in the 55 patients at TEE. These results were then used as a reference point for CT angiography. Based on this comparison Hur and colleagues established overall sensitivity, specificity, and positive and negative predictive values of cardiac CT angiography as 100 percent, 98 percent, 93 percent, and 100 percent, respectively. Full results of the study were published online in Radiology.
From "Left Atrial Appendage Thrombi in Stroke Patients: Detection With Two-Phase Cardiac CT Angiography Versus Transesophageal Echocardiography"
Radiology Online (04/14/09) Hur, Jin; Kim, Young Jin; Lee, Hye-Jeong
Research
DCE-MRI Images Intratumoral Hypoxia in Patients With HNC
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can be used to detect intratumoral hypoxia in patients with head-and-neck cancer (HNC), according to a study conducted by Dr. Kate Newbold of the Royal Marsden Hospital and colleagues. Their research analyzed 23 regions of interest from seven patients using DCE-MRI. These studies found a number of statistically significant correlations between DCE-MRI parameters and areas with a pimonidazole score of 4 or carbonic anhydrase 9 (CA9). However, the same correlation was not found between CT parameters and pimonidazole staining or CA9.
From "An Exploratory Study Into the Role of Dynamic Contrast-Enhanced Magnetic Resonance Imaging or Perfusion Computed Tomography for Detection of…"
International Journal of Radiation Oncology, Biology, Physics (05/09) Vol. 74, No. 1, P. 29; Newbold, Kate; Castellano, Isabel; Charles-Edwards, Elizabeth
Phosphorus Magnetic Resonance Spectroscopy Detects Myocardial CK Metabolite Concentrations
Researchers, led by Dr. Paul A. Bottomley of the Johns Hopkins University Division of MR Research, were recently able to use phosphorus magnetic resonance spectroscopy to noninvasively detect myocardial creatine kinase (CK) metabolite concentrations in 15 patients. By doing so, Bottomly and colleagues found that CK kinetics in prior human myocardial infarction (MI) demonstrate that CK adenosine triphosphate (ATP) supply is significantly reduced as a result of substrate depletion.
From "Reduced Myocardial Creatine Kinase Flux in Human Myocardial Infarction"
Circulation (04/14/09) Bottomley, Paul A.; Wu, Katherine C.; Gerstenblith, Gary
Saline-Infusion Sonography Endometrial Sampling Provides Improved Diagnosis for Endometrial Pathology
Saline-infusion sonography endometrial sampling is more accurate than endometrial biopsy for the diagnosis of endometrial pathology in postmenopausal and perimenopausal women with abnormal uterine bleeding. This conclusion was reached by Dr. Elysia Mochos et al. in a study of 88 women aged 40 years and older with abnormal uterine bleeding who had undergone endometrial biopsy. Saline-infusion sonography endometrial sampling was then performed at the end of sonohysterography using an endometrial sampling curette at the site of the endometrial abnormality. Saline-infusion sonography endometrial sampling provided a diagnosis 89 percent of the time, while endometrial biopsy produced a diagnosis 52 percent of the time.
From "Saline-Infusion Sonography Endometrial Sampling Compared With Endometrial Biopsy in Diagnosing Endometrial Pathology"
Obstetrics & Gynecology (04/01/09) Vol. 113, No. 4, P. 881; Moschos, Elysia; Rahella, Ashfaq; McIntire, Donald D.
Routine Multidetector CT Identifies Corona Mortis
Multidetector computed tomography (CT) can identify the corona mortis variant in approximately one-third of patients, according to a recent study led by Loma Linda University Prof. Jason C. Smith. For the purposes of this study, Smith and colleagues evaluated 50 consecutive patients undergoing venous phase contrast-enhanced CT of the pelvis - 25 using a 16-slice scanner and 25 using a 64-slice scanner. Results of their evaluation showed that the corona mortis was most easily imaged using 1.25-mm CT reconstructions and 64-slice images. Smith and his team are hopeful that these images could be used to aid the embolization of a hemorrhaging corona mortis by saving "valuable time, contrast medium, radiation, and operator stress in the trauma scenario."
From "The Corona Mortis, a Frequent Vascular Variant Susceptible to Blunt Pelvic Trauma: Identification at Routine Multidetector CT"
Journal of Vascular and Interventional Radiology (04/09) Vol. 20, No. 4, P. 455; Smith, Jason C.; Gregorius, John C.; Breazeale, Bretton H.
Technology
New Computer Model Classifies Mammographic Findings
University of Wisconsin Prof. Elizabeth S. Burnside and colleagues recently were able to create a Bayesian network that can predict the probability of breast cancer and exceed interpreting radiologist performance. The Bayesian network was based on structured reports from 48,744 consecutive pooled screening and diagnostic mammography examinations in 18,269 patients. Mammographic findings were matched with a state cancer registry. By using 10-fold cross validation, the Bayesian network was tested and trained to estimate breast cancer risk by using demographic risk factors and mammographic findings recorded in the Breast Imaging Reporting and Data System lexicon. Full details of the network's development its performance can be found in Radiology.
From "Probalistic Computer Model Developed From Clinical Data in National Mammography Database Format to Classify Mammographic Findings"
Radiology Online (04/14/09) Burnside, Elizabeth S.; Davis, Jesse; Chhatwal, Jagpreet
Researchers Develop New Imaging Biomarker for Early Cancer Treatment Outcome
A new MR imaging protocol, known as the parametric response map (PRM), is able to accurately evaluate survival times for patients with high-grade glioma (HGG) as early as one week following the initiation of treatment. The protocol, tested by University of Michigan Prof. Craig J. Galban and colleagues, uses a voxel-wise approach for image analysis and quantification of hemodynamic alterations during treatment. To determine the accuracy of PRM, Galban et al. performed MRIs in 44 patients with HGG one week before treatment with chemotherapy and radiation as well as one week and three weeks following treatment. Researchers then used relative cerebral blood volume (CBV) and relative cerebral blood flow (CBF) of the tumor to analyze voxel-wise changes among the serial scans. By using PRM, researchers were able to identify CBF and CBV changes that were not identifiable using the standard approach.
From "The Parametric Response Map Is an Imaging Biomarker for Early Cancer Treatment Outcome"
Nature Medicine (04/09) Galban, Craig J.; Chenevert, Thomas L.; Meyer, Charles R.
Micro-CT Provides Solution for the Evaluation of Angiogenesis in a Xenograph Mouse Model of Lung Cancer
High-resolution micro-computed tomography (micro-CT) was recently used by a group of researchers, led by Justus-Liebig-University Prof. Rajkumar Savai, to evaluate lung tumor angiogenesis. Previously this type of evaluation has been limited due to difficulties generating reproducible data. However, researchers were able to use micro-CT to perform a quantitative analysis of lung tumor micro vessels. These observations using micro-CT were found to correlate with immunohistochemical measurement of microvessels, leading researchers to believe that micro-CT is a novel method for the investigation of lung tumor angiogenesis and might be considered as an additional complementary tool for the precise quantification of angiogenesis.
From "Evaluation of Angiogenesis Using Micro-Computed Tomography in a Xenograft Mouse Model of Lung Cancer"
American Association for Cancer Research (04/21/09)
Clinical Practice
CT Colonography Found to Be a Cost-Effective Method of Screening for Colorectal Cancer and AAA
University of Wisconsin Prof. Perry J. Pickhardt and colleagues have found that CT colonography (CTC) is a highly cost-effective and clinically efficacious screening strategy for the Medicare population due to its ability to screen for both colorectal cancer and abdominal aortic aneurysm (AAA). This conclusion is based on a computerized Markov model that simulated the development of colorectal cancer and AAA in a hypothetical cohort of 100,000 adults over the age of 65 years. The model found that CTC resulted in 7,786 and 7,027 life-years gained when patients were screened at five- and 10-year intervals, compared to 6,032 life-years gained when patients were screened every 10 years using primary optical colonoscopy.
From "CT Colonography to Screen for Colorectal Cancer and Aortic Aneurysm in the Medicare Population: Cost-Effectiveness Analysis"
American Journal of Roentgenology (05/01/2009) Pickhardt, Perry J.; Hassan, Cesare; Laghi, Andrea
Industry News
Radiology's Shine Fades a Bit Among Medical Students
Radiology remains in the top 10 specialty choices for U.S. medical school seniors, but has fallen to number eight from its place of number five in 2007, according to the 2009 National Residency Matching Program (NRMP). The number of U.S. and foreign medical students and physicians who applied for radiology residency and internships rose slightly more than 2 percent this year. In spite of this increase, the annual growth of these applications have become progressively smaller in the last five years, according to Dr. Howard P. Forman, chair of the American College of Radiology's Committee on Radiologist Resources. NRMP officials said that nearly 30,000 applicants- more than half U.S. medical school seniors - applied for this year's residency program.
From "Radiology's Shine Fades a Bit Among Medical Students"
Diagnostic Imaging (04/14/09) Abella, H. A.
RSNA Weekly is a briefing of the latest radiology-related news selected from hundreds of sources by the editors of Information, Inc. While care is taken to use good sources, inaccuracies in source material are not the responsibility of RSNA or Information, Inc.
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