Submit 2010 R&E Grant Applications
RSNA Membership Now Required for Grants
Applications are being accepted for R&E research and education grants. Applicants for 2010 R&E grants are now required to be RSNA members (at any level) at the time of application.
Application deadlines are:
January 10: Education Grants
January 15: Research Grants
February 1: Medical Student Grant
For more information on all Foundation grant and recognition programs, including current and past grant projects, go to RSNA.org/Foundation or contact Scott Walter, M.S., assistant director, grant administration at 1-630-571-7816 or swalter@rsna.org.
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Leading the News
U.S. House Approves Bill to Fund U.S. Mo-99 Production
The U.S. House of Representatives has approved a bill that will allocate $163 million to support projects that encourage the production of molybdenum-99 (Mo-99) in the United States without using highly enriched uranium. It also includes language that other medical isotopes, including iodine-131 and xenon-133, must be produced as byproducts of Mo-99 fission. The U.S. Department of Energy will use the funding provided by the bill to support private-sector and academic research projects to produce Mo-99. Additionally, the law prohibits the exportation of highly enriched uranium from the United States for medical isotope production seven years after the bill becomes law. After passing in the House, the legislation will now head to the Senate, where is it not expected to face any significant roadblocks.
From "U.S. House Approves Bill to Fund U.S. Mo-99 Production"
AuntMinnie.com (11/06/09) Forrest, Wayne
Research
Stereotactic Radiotherapy Offers Noninvasive, Effective Treatment for Lung Cancer Patients
A national clinical trial led by physicians from the University of Texas Southwestern Medical Center shows that stereotactic body radiation therapy (SBRT) should be considered a new standard for the treatment of early-stage lung cancer in patients with co-existing medical problems. In the study, 55 patients diagnosed with early non-small-cell lung (NSCL) cancer who were unable to have their tumors surgically removed because of unrelated medical comorbidities were treated with SBRT in three noninvasive outpatient sessions. The findings, presented in early November at the annual meeting of the American Society for Therapeutic Radiology and Oncology, shows that the primary lung cancer did not recur 98 percent of the time. Despite their fragile condition, more than half of these patients (56 percent) were alive three years after their diagnosis, and less than 20 percent died of metastatic lung cancer. "These findings have changed the standard of care for lung cancer in patients with serious medical problems like emphysema, heart disease and strokes," says UT Southwestern vice chairman of radiation oncology Dr. Robert Timmerman, the principal investigator of the Radiation Therapy Oncology Group 0236 study. SBRT delivers multiple high-dose radiation beams to a tumor in a concentrated and extremely precise manner. Each individual beam is relatively weak and causes very little damage while traveling through the body, but when the beams combine at their target, the cumulative effect creates an extremely potent dose that destroys the target cells. "Despite the high potency of the treatment, less than 20 percent of these extremely frail patients experienced a serious health decline," says Timmerman, one of the top international experts on stereotactic radiotherapy. Timmerman says the results of the study were better than expected, and the treatment contains similar risks as radical surgery, which has been the standard treatment of early-stage NSCL for the past century. Timmerman notes that SBRT is fast, convenient, and very effective, and the success of the study warrants ongoing clinical research into the use of SBRT to treat healthier patients with early-stage NSCL.
From "Stereotactic Radiotherapy Offers Noninvasive, Effective Treatment for Lung Cancer Patients"
ScienceDaily (11/02/09)
CCA Found to Improve Visualization and Quantification of Lung Perfusion in MRI
The application of cross-correlation analysis (CCA) has been found to improve the visualization and quantification of lung perfusion in MRI. Researchers reached this conclusion after performing perfusion MRI on the lungs of seven healthy volunteers. CCA was then performed pixel-wise in lung segmentations using the signal time-course of the main pulmonary artery and left atrium as references. Pixels with high correlation coefficients were considered as arterial or venous and excluded from further analysis and quantitative perfusion parameters were calculated for manual lung segmentations separately. Using CCA for vascular suppression also significantly reduced perfusion parameters.
From "Suppression of Pulmonary Vasculature in Lung Perfusion MRI Using Correlation Analysis"
European Radiology (11/01/09) Vol. 19, No. 11, P. 2569; Risse, Frank; Kuder, Tristan A.; Kauczor, Hans-Ulrich; et al.
XFM and DCE MRI Reveals Gadolinium Uptake Within Neoplastic Mammary Ducts in a Murine Model
Researchers were able to unambiguously identify ductal carcinoma in situ (DCIS) on MR images, providing insight into the physiologic basis of contrast enhancement of DCIS lesions on dynamic contrast material-enhanced (DCE) MRI. According to their study, published in the November 2009 issue of Radiology, DCE MR imaging in animal models also revealed gadolinium uptake along the length of ducts with DCIS. Additionally, researchers performed x-ray fluorescence microscopy, which showed gadolinium uptake inside ducts with DCIS.
From "X-ray Fluorescence Microscopy and Dynamic Contrast-enhanced MR Imaging Reveals Gadolinium Uptake within Neoplastic Mammary Ducts in a Murine Model"
Radiology (11/01/09) Vol. 253, No. 2, P. 399; Jansen, Sanaz A.; Paunesku, Tatjana; Fan, Xiaobing; et al.
Technology
Researchers Develop Innovative Imaging System to Study Sudden Cardiac Arrest
Vanderbilt University researchers have developed a new optical imaging system that can simultaneously image electrical activity and metabolic properties in the same region of the heart. The researchers are hopeful that the system could aid clinical studies designed to understand the relationship between metabolic disorders and heart rhythm disturbances in humans that can lead to cardiac arrest and death, and provide a platform for testing new treatments for arrhythmias. The multimodal cardiac imaging technique uses a two-camera approach to integrate electrophysiological imaging with optical fluorescence imaging of metabolic activity associated with damaged heart tissue and tachycardia. The biochemical and electrochemical studies of heart tissue under controlled conditions will enhance scientists' understanding of electrometabolic cardiac disorders and their clinical treatment. The advantages of this imaging system over others include rapid setup, two-color image separation, high spatial resolution, and an optional software camera calibration routine that eliminates the need for precise camera alignment. In addition, the researchers say the multimodal imaging system will provide a less-invasive instrumental tool in helping scientists discover and test safe and effective treatments for arrhythmias.
From "Researchers Develop Innovative Imaging System to Study Sudden Cardiac Arrest"
NIH News Release (10/30/09)
Medical-Legal Issues
2010 Medicare Fee Schedule Boosts Equipment Utilization Rate
The Centers for Medicare & Medicaid Services (CMS) has announced the official fee schedule for 2010. The new fee schedule raises the utilization rate for diagnostic imaging systems from 50 percent to 90 percent. However, Congress is expected to change this formula as the House healthcare reform bill would increase the assumed utilization rate for advanced imaging equipment to 75 percent while the Senate Finance Committee proposes a 65 percent utilization rate. Additionally, CMS will now require all suppliers of the technical component of advanced imaging services be accredited by Jan. 1, 2012. This requirement will apply to mobile radiology units, physicians' offices, and independent diagnostic testing facilities, but would exempt physicians who interpret the scans.
From "2010 Medicare Fee Schedule Boosts Equipment Utilization Rate"
Diagnostic Imaging (11/02/09) Brice, James
CMS Backs Down on 19 Percent Cut
The Centers for Medicare & Medicaid Services (CMS) has announced that it will not make the proposed 19 percent cut in reimbursement rates for radiation oncology. As an alternative, CMS will implement a 5 percent reduction phased in over a four-year period. Therefore, Medicare and Medicaid reimbursement rates for radiation oncology will be reduced 1 percent for calendar year 2010.
From "Radiation Oncology Celebrates as CMS Backs Down on 19 Percent Cut"
AuntMinnie.com (11/02/09) Keen, Cynthia E.
Clinical Practice
Optimum ADC Determination and DW Imaging Quality Improves Accuracy for Differentiation of Benign and Malignant Breast Tumors
A study published in the November 2009 issue of Radiology shows that optimum apparent diffusion coefficient (ADC) determination and diffusion-weighted (DW) imaging quality improve the accuracy of differentiation between benign and malignant breast tumors. Researchers based this conclusion on a 51-patient study, which established 112 regions of interest drawn in 24 malignant, 17 benign, 20 cystic, and 51 normal tissue regions. ADC maps were calculated for combinations of 10 b values, and differences in ADC among tissue types were evaluated. The contrast-to-noise ratio of lesions at DW imaging also were compared for all b values. A repeated-measures analysis of variance was then used to assess lesion differentiation.
From "Diffusion-Weighted MR for Differentiation of Breast Lesions at 3.0 T: How Does Selection of Diffusion Protocols Affect Diagnosis?"
Radiology (11/01/09) Vol. 253, No. 2, P. 341; Bogner, Wolfgang; Gruber, Stephan; Pinker, Katja; et al.
PET Imaging Before Radiation Found Not to Be Ideal for Determining Boost Radiation Doses
Research from Thomas Jefferson University Hospital shows that positron emission tomography (PET) imaging of non-small cell lung cancer before receiving radiation therapy should not be the foundation for determining areas that may benefit from higher doses of radiation. Some studies have suggested that areas with the highest amount of hypermetabolic activity on a PET scan before treatment are the areas most likely to have increased activity after treatments, according to Thomas Jefferson University Hospital Radiation Oncology resident Nitin Ohri, MD. "Investigators are looking to PET imaging [to] find ways to predict if any part of the tumor would benefit from a higher radiation dose," says Ohri. "I wanted to see if residual activity on a scan after treatment correlates with the activity pattern on a scan done before treatment." Ohri examined the PET scans of 43 patients, of which 15 had significant activity on the scans both before and after treatment. Ohri then set up a coordinate system that divided tumors into nine regions, or 17 regions for larger tumors, and correlated the activity in the regions both before and after treatment. Ohri found that in some patients the activity pattern was similar in regions before and after treatment, but that there also were some patients who showed activity in completely different areas after treatment. "It’s not sufficient to increase the dose to areas that are especially active on PET imaging before treatment and expect that to improve the control rate," says Ohri. "It may be more appropriate to do a scan halfway through treatment and plan additional radiation dose[s] around that."
From "PET Imaging Before Radiation Not Ideal for Determining Boost Radiation Doses"
Newswise (10/30/09)
Getting Medical Images Into the EHR
Earlier this year, Middletown, N.Y.-based Crystal Run Healthcare implemented a new radiology information system/picture archiving and communication system (RIS/PACS) from Carestream Health in Rochester, N.Y., and two Kodak digital radiography imaging modalities and a Kodak computed radiography modality. The RIS/PACS went live in July, and Crystal Run is working to integrate the new system with its electronic health records (EHRs). Crystal Run already has some RIS/PACS-EHR integration experience, so the practice is looking to create a more comprehensive integration this time, according to managing partner Hal Teitelbaum, M.D. "We are beyond looking at the relatively simple issue of storing data," says Teitelbaum. "Now, we're looking to utilize the data." Now, patient demographic information entered into the EHR automatically transfers to the RIS/PACS, preventing double entry. When integration is completed in 2010, orders will flow from the EHR to the imaging software, and other critical patient data, like kidney function test results, will flow to radiologists and technicians to ensure the proper amount of radiation is used. Through the system, physicians will be able to view medical images from the EHR, instead of having to go to the radiology or cardiology departments. Better integration is easier today than even a few years ago because imaging, EHR, and integration technologies are far more mature, according to Teitelbaum. The first step in radiology integration is integrating imaging modalities, including MRI, ultrasound, CT scan, and other systems, with the RIS/PACS. Integration into the EHR is done through the RIS, PCAS, or both. Modern integration efforts are greatly helped by a widespread willingness between vendors to collaborate on scalability issues.
From "Getting Medical Images Into the EHR"
Information Management (11/04/09) Goedert, Joseph
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