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Non-member registration and housing open tomorrow, May 27, for RSNA 2009.
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Encourage your non-member colleagues to register for RSNA 2009 at RSNA.org/Register.
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Research
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From RSNA
Featured in RadioGraphics: Best Cases from the AFIP
A new case from the Armed Forces Institute of Pathology (AFIP) addresses the radiologic and pathologic findings of telangiectatic osteosarcoma. This subtype of osteosarcoma constitutes 2.5 to 12 percent of all osteosarcomas and is believed to originate from transformed osteoblasts or from stem cells that derive from mesenchymal tissue.
The clinical manifestations of telangiectatic osteosarcoma resemble those of conventional osteosarcoma and patients most often present with local tenderness or pain, a soft-tissue mass and fracture. Read more about “Telangiectatic Osteosarcoma: Radiologic and Pathologic Findings,” by Federico Discepola, M.D., and colleagues, in the current issue of RadioGraphics.
Leading the News
Medical Community Could Face Isotope Shortage After Reactor Shutdown
The shutdown of a nuclear reactor in Chalk River, Ontario, due to a heavy water leak is expected to produce a shortage of diagnostic isotopes for use in medical imaging until the reactor is repaired and back in operation. About half of the global supply of medical-imaging isotopes—and about 80 percent of the Canadian supply—is supplied by the facility, which is expected to be out of service for over a month. "We'll be good for the next week, but the next three weeks will be really difficult after that," says Dr. Doug Abrams, head of the Canadian Society of Nuclear Medicine, which quickly began examining supply options. Canadian officials say the plant's leaking heavy water was contained and is being stored, with no threat to the public or to the environment, and there was no risk of a nuclear accident.
From "Medical Community Could Face Isotope Shortage After Reactor Shutdown"
Canadian Press (05/19/09)
Research
Researchers Detect Common MR Findings in Asymptomatic Elbows
In order to detect common MR findings in asymptomatic elbows, researchers recruited 60 subjects to undergo MR imaging. Increased signal intensity (SI) was compared with surrounding muscles on fluid-sensitive MR images. Anatomic course, anatomic nerve, and muscle variants potentially associated with nerve compression syndromes and qualitative changes in nerve diameter were also evaluated. Increased SI of the ulnar nerve was found in 60 percent of fluid-sensitive images while atypical intermuscular course of the median nerve was found in 17 percent and an anconeus epitrochlearis muscle was found in 23 percent. The study was published at Radiology Online May 18, 2009.
From "Elbow Nerves: MR Findings in 60 Asymptomatic Subjects—Normal Anatomy, Variants, and Pitfalls"
Radiology Online (05/18/09) Husarik, Daniela B.; Saupe, Nadja; Pfirrmann, Christian W.A.
CT Hypotension Complex (Shock Bowel) Is Not Always Due to Traumatic Hypovolemic Shock
A study was conducted of clinical and CT findings in a sample of 41 patients with CT hypotension complex to see if shock bowel and other CT signs of hypotension are tied to other conditions besides post-traumatic hypovolemic shock, such as severe head or spine injury, cardiac arrest, septic shock, bacterial endocarditis, and diabetic ketoacidosis. Other CT hypotension complex components—such as flattening of the inferior vena cava and aorta, abnormal pancreatic enhancement and peripancreatic fluid, and hypoperfusion of the spleen and live—are variably affiliated with shock bowel whether caused by posttraumatic hypovolemia or other hypotension factors. The researchers conclude that shock bowel has vital prognostic and therapeutic implications and, in most instances, can probably be differentiated from bowel trauma and other forms of bowel injury.
From "CT Hypotension Complex (Shock Bowel) Is Not Always Due to Traumatic Hypovolemic Shock"
American Journal of Roentgenology (05/01/2009) Vol. 192, No. 5, P. W230; Ames, Jennifer T.; Federle, Michael P.
Tissue Doppler Imaging Establishes Determinants of LV Early-Diastolic Lengthening Velocity
Peak early-diastolic mitral annulus velocity (e') by tissue Doppler imaging has been established as a clinical marker of diastolic function. Left ventricular (LV) relaxation is used to detect e'. However, a team of researchers in Oslo, Norway, found that restoring forces and lengthening load in the nonfailing ventricle are also important determinants of early-diastolic lengthening velocity. This conclusion is based on sonomicrometry and tissue Doppler imaging performed in animal models during baseline, volume loading, caval constriction, dobutamine infusion, and occlusion of the left anterior descending coronary artery. Relaxation was measured as the time constant of LV pressure decay by micromanometer while lengthening load was measured as LV transmural at mitral valve opening.
From "Determinants of Left Ventricular Early-Diastolic Lengthening Velocity"
Circulation (05/19/09) Vol. 119, No. 19, P. 2578; Opdahl, Anders; Remme, Espen W.; Helle-Valle, Thomas
CT Scans Effective for Chest Pain Diagnosis
New research from the University of Pennsylvania School of Medicine indicates that coronary computerized tomographic angiography (CTA) is an effective and safe method for confirming that patients who come to hospital emergency rooms with chest pain are not suffering from serious cardiovascular disease. Nearly 500 patients who received negative CTA scans were tracked by investigators for one year after their hospital visit. Eleven percent of the patients were rehospitalized and 11 percent received additional cardiac testing over the following year, but none suffered heart attacks or required revascularization procedures to open obstructed coronary arteries. The study authors say the findings offer guidance for the appropriate and cost-effective use of CTA technology, which produces three-dimensional photos of the heart and the surrounding blood vessels. Earlier Penn research demonstrated that CTA is a faster and less costly method for screening low-risk chest pain patients than conventional testing. The latest study was presented at the recent Society for Academic Emergency Medicine's annual conference.
From "CT Scans Effective for Chest Pain Diagnosis"
eMaxHealth.com (05/18/09)
Study Sees Transient Heart Dysfunction in Some Long-distance Runners
A new study from University of Manitoba researchers using cardiac magnetic resonance (CMR) imaging has determined that cardiac dysfunction experienced by some marathon runners following competition is transient and does not cause damage to the heart muscle. The cardiac health of 14 "non-elite" runners who performed in the full 2008 Manitoba Marathon in Winnipeg, Canada, was studied. Each participant underwent a comprehensive health screening, including blood tests to determine the levels of cardiac biomarkers, before the marathon. Additional blood samples were taken, and echocardiograms and CMR were performed after the event. "Although previous studies of marathon runners have demonstrated biochemical evidence of cardiac injury and have correlated these findings with echocardiographic evidence of cardiac dysfunction, this was the first time CMR has been used to further evaluate and understand the effects of marathon running on the heart," said St. Boniface General Hospital Research Center professor Davinder S. Jassal, MD. Cardiac biomarkers were elevated after the race, but there was no evidence of direct permanent injury to the heart muscle on CMR imaging. "By using CMR, we were able to definitively show that these fluctuations do not result in any true damage of the heart, and the right ventricular dysfunction is transient, recovering one week following the race," Jassal concluded. The research was presented at the 105th International Conference of the American Thoracic Society on May 17.
From "Study Sees Transient Heart Dysfunction in Some Long-distance Runners"
EurekAlert (05/17/09) Savoie, Keely
Technology
VBM and MTI Provide Improved Detection of Prefrontal and Anterior Cingulate Cortex Abnormalities in Tourette Syndrome
Voxel-based morphometry (VBM) and magnetization transfer imaging (MTI) have been found to be more sensitive to tissue alterations than conventional MRI and provide a quantitative measure of macrostructural integrity. For these reasons, researchers elected to use the two modalities to image alterations in frontostriatal circuitries associated with Tourette Syndrome (TS). Using VBM, the researchers found that TS patients showed significant decreases in gray matter volumes in the prefrontal areas, anterior cingulate gyrus, sensorimotor areas, left caudate nucleus, and left postcentral gyrus. Decreases in white matter volumes were also detected in the right inferior frontal gyrus, left superior frontal gyrus, and anterior corpus callosum. Increases were found in the middle frontal gyrus and left sensorimotor areas. Additionally, MTI detected white matter reductions in the right medial frontal gyrus, inferior frontal gyrus, and right cingulate areas.
From "Prefrontal and Anterior Cingulate Cortex Abnormalities in Tourette Syndrome: Evidence From Voxel-Based Morphometry and Magnetization Transfer Imaging"
BMC Neuroscience (05/09) Vol. 10, No. 47, Muller-Vahl, Kirsten R.; Kaufmann, Jorn; Grosskreutz, Julian
Medical-Legal Issues
HHS Announces Members of Committees That Will Advise on Implementation of Health IT
The Department of Health and Human Services (HHS) has announced the appointment of three members of the Health Information Technology (HIT) Policy Committee as well as members of the HIT Standards Committee. Both advisory committees were created by the American Recovery and Reinvestment Act to help improve health IT and increase its use in current healthcare reform efforts. To this end, the HIT Policy Committee will make recommendations to the National Coordinator for Health Information Technology on a policy framework for the development and adoption of a nationwide interoperable health information infrastructure designed to ensure the secure exchange of patient medical records. HHS appointees to the committee include Dr. David Blumenthal, the HHS National Coordinator for HIT, Dr. Michael Klag of the Johns Hopkins Bloomberg School of Public Health, and Deven C. McGraw, Director of the Health Privacy Project of the Center for Democracy & Technology.
From "HHS Announces Members of Committees That Will Advise on Implementation of Health IT"
HHS News Release (05/08/09)
Clinical Practice
DICOM Improves Radiology and Radiation Therapy Workflow
Multiple stand-alone systems employing technological innovations in imaging, treatment planning, and treatment delivery gather or produce key data during the course of radiation therapy, but efficient clinical workflow is hampered because this data is scattered across various systems throughout the radiation therapy department. The Digital Imaging and Communications in Medicine (DICOM) standard was extended from radiology to radiation therapy with the ratification of seven DICOM-RT objects in 1997 and 1999. These objects helped standardize data integration and interoperability between radiation therapy gear and information systems from different manufacturers, as well as the use of DICOM diagnostic images in radiation therapy. Key radiation therapy imaging and informatics data has more recently been combined into an open-architecture comprehensive radiation therapy electronic patient record system, which carries three advantages. The system can be used as a platform for performing effective and efficient clinical services, as a foundation for radiation therapy data exchange and expert consultation, and for medical imaging informatics research in devising advanced decision support tools and a knowledge base for enhanced treatment with radiation therapy. The review was published at RadioGraphics Online May 15, 2009.
From "DICOM-RT-based Electronic Patient Record Information System for Radiation Therapy"
RadioGraphics (05/09) Law, Maria Y.Y.; Liu, Brent; Chan, Lawrence W.
Industry News
Report Predicts Thaw in Deep Freeze of New Equipment Installations
Hospital radiology equipment installations in the United States got off to a slow start this year, but most radiology administrators are expecting that they will be able to acquire equipment later this year as restrictions on capital acquisitions ease. Many facilities found themselves in a poor position because of last year's credit crunch, according to a study of 250 U.S. acute care hospitals, with partial or total capital equipment spending freezes seen at about 70 percent of radiology departments surveyed. "In 2009, capital budgeting thus far has been an issue because of partial or complete freezes, so budgets have gone out the window. Budgets are a moot point," says Mary C. Patton of IMV, the healthcare market research company that conducted the survey. Other findings in IVM's Diagnostic Imaging Procedures and Purchases report include: delays were more common than cancellations for planned purchases; departments are looking to move from analog to digital imaging; two out of five PACS users are planning to buy one or more PACS upgrades in the next two years; 80 percent of administrators refuse to downgrade expectations for imaging technology and features; and two-thirds of administrators say there will be selected capital projects at their hospitals this year in spite of the economic downturn.
From "Report Predicts Thaw in Deep Freeze of New Equipment Installations"
Diagnostic Imaging (05/14/09) Brice, James
Senate Confirms Obama's Pick for FDA Chief
The U.S. Senate has confirmed President Barack Obama's choice for FDA chief, Dr. Margaret Hamburg. A bioterrorism expert and assistant health secretary under President Bill Clinton, her first priority will be to direct development of a vaccine for swine flu. Hamburg told senators that she intends to restore public confidence in the FDA.
From "Senate Confirms Obama's Pick for FDA Chief"
Associated Press (05/19/09) Alonso-Zaldivar, Ricardo
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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