Applications Being Accepted for International Young Academics
The RSNA Introduction to Research for International Young Academics program encourages young radiologists from countries outside the U.S. and Canada to pursue careers in academic radiology. The program consists of a special seminar held during the RSNA annual meeting.
The nomination deadline is April 15. Eligible candidates are residents and fellows currently in radiology training programs or radiologists not more than two years out of training who are beginning or considering an academic career. Nominations must be made by the candidate’s department chairperson or training director. Fluency in English is required.
Nomination forms can be found online.
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Leading the News
New Cardiac CT Technology Drastically Reduces Patient Radiation Exposure
Researchers have found that an imaging exam of the heart using the latest generation of 320-detector row volume CT scanners exposes patients to up to 91 percent less radiation than standard CT scans. Their work, published in the March 2010 issue of Radiology, shows that this reduction is likely due to the fact that the 320-detector row scanner is able to image 16 centimeters (or the entire length of the heart) in a single rotation and within a single heartbeat. Standard 64-detector row scanners image 4 centimeters at a time. For the study, researchers compared the radiation exposure incurred during a coronary CT angiography using 64-detector row helical scanning and volume scanning, using a 320-detector row volume CT scanner. Phantoms simulating female and male bodies were imaged using six different scan modes.
From "Radiation Dose From Single-Heartbeat Coronary CT Angiography Performed With a 320–Detector Row Volume Scanner"
Radiology (03/01/10) Vol. 254, No. 3, P. 698; Einstein, Andrew J.; Elliston, Carl D.; Arai, Andrew E.; et al.
Research
Combined Mammography and Breast MRI Useful for Some High-Risk Women
Annual breast cancer screening with both mammography and MRI is likely to be a cost-effective way to improve life expectancy in women with an increased risk of breast cancer, according to a study published in the March 2010 issue of Radiology. Women with certain mutations of the BRCA1 gene have a significantly increased risk of developing breast cancer. However, mammography detects fewer than half of breast cancers in these high-risk women. For this reason, MRI provides a useful adjunct for screening women at increased genetic risk of breast cancer, despite its higher incidence of false-positive findings. Researchers compared the costs and benefits of film mammography and of combined mammography and MRI in a hypothetical group of 25-year-old women with BRCA1 mutations. They then used statistical modeling to estimate the number of quality-adjusted years gained by screening, as well as lifetime costs. Women undergoing annual combined screening with both mammography and MRI gained 49.62 quality-adjusted years, while annual MRI alone provided 49.50 and annual mammography alone provided 44.46.
From "Cost-Effectiveness of Breast MR Imaging and Screen-Film Mammography for Screening BRCA1 Gene Mutation Carriers"
Radiology (03/01/10) Vol. 254, No. 3, P. 793; Lee, Janie M.; McMahon, Pamela M.; Kong, Chung Y.; et al.
ECG-Gated Cardiac CT Angiography Detects Mitral Valve Prolapse
ECG-gated Cardiac 64-MDCT angiography can be used to reliably detect mitral valve prolapse. This conclusion is based on findings from a study cohort of patients who had undergone transthoracic echocardiography and 64-MDCT angiography. Two experienced radiologists performed a blinded review of the MDCT angiograms of 20 patients. These findings were then compared to the transthoracic echocardiography results. Sensitivity for MDCT angiography to detect mitral valve prolapse was found to be between 69.2 percent and 84.6 percent depending on reference points, while specificity was 100 percent. Positive and negative predictive values were estimated to be 100 percent and between 87 percent and 93.1 percent.
From "Mitral Valve Prolapse: Evaluation With ECG-Gated Cardiac CT Angiography"
American Journal of Roentgenology (03/10) Vol. 194, No. 3, P. 579; Shah, Rajnil G.; Novaro, Gian M.; Blandon, Rodolfo J.; et al.
Technology
Medical Scan Makers to Install Radiation Controls
The Medical Imaging & Technology Alliance announced on Feb. 25 that computed tomography (CT) scanner manufacturers will start installing safety controls to prevent radiation overdoses. The announcement followed the U.S. Food and Drug Administration's (FDA) declaration that it would begin to clamp down on excessive radiation scanning. Hundreds of acute radiation overdoses from CT scanners were reported by three California hospitals in 2009, while the FDA estimates that the average American's total radiation exposure has almost doubled in the last 30 years primarily on account of next-generation imaging tests. The FDA crackdown also targets nuclear imaging machines and other types of scanners, and the Medical Imaging & Technology Alliance said it was still striving to deploy changes with those scanners' makers. Older machines will be upgraded through software changes. "It's important to understand that this is a rolling initiative," said the Alliance's Dave Fisher. "It won't happen overnight."
From "Medical Scan Makers to Install Radiation Controls"
Associated Press (02/26/10)
Researchers Develop New Visualization Method for Laparoscopic Surgery Using Continuous Volumetric CT
The authors of a recent study have developed live augmented reality (AR), a new surgical visualization approach that combines the benefits of a laparoscope with continuous CT scanning in the surgical field. They were also able to achieve considerable x-ray dose reduction while allowing continued visualization of the vasculature. In recent animal models, researchers found that superior compensation for soft tissue deformations using the new method led to more accurate spatial registration between laparoscopic and rendered CT images with live AR compared to conventional AR. Additionally, substitution of low-dose CT with registered initial CT offered at least an eightfold reduction in intraoperative x-ray dose.
From "Live Augmented Reality: A New Visualization Method for Laparoscopic Surgery Using Continuous Volumetric CT"
Surgical Endoscopy (02/20/2010) Shekhar, Raj; Dandekar, Omkar; Bhat, Venkatesh; et al.
Medical-Legal Issues
Congress Surprised at Lack of Medical Radiation Oversight
During hearings in the U.S. Congress on Feb. 26, federal lawmakers expressed surprise at the lack of regulatory oversight over medical uses of radiation. At the hearings, members of the U.S. House of Representatives subcommittee on health heard from members of organized medicine, patients, and other experts about the need to fix the current regulatory environment. But the question of how to fix it remained unsolved. "As valuable, informative, thought-provoking, and incredibly useful as your testimony was today, we've ended up with more questions," said Rep. Frank Pallone Jr. (D-N.J.), chairman of the subcommittee. "Before we move on any legislation, we'll need to have more hearings to get answers to our questions."
From "Congress Surprised at Lack of Medical Radiation Oversight"
AuntMinnie.com (02/26/10) Keen, Cynthia E.
Clinical Practice
Researchers Urge Radiologists to Familiarize Themselves With the Different Appearances of Pericardial Recesses on MDCT
Visualization rates of pericardial recesses are higher with 4-, 16-, and 64-slice multidetector CT (MDCT), leading researchers to recommend that radiologists ensure they are familiar with the different appearances of pericardial recesses on MDCT to avoid misdiagnosis. Specifically, researchers who analyzed 588 MDCT scans found that the visualization rates for 4-, 16-, and 64-slice MDCT were 90.6 percent, 90.3 percent, and 88.7 percent, respectively.
From "Evaluation of Pericardial Sinuses and Recesses With 2-, 4-, 16-, and 64-row Multidetector CT"
La Radiologia Medica (02/23/10) Ozmen, C. A.; Akpinar, M. G.; Akay, H. O.; et al.
Industry News
Private Practice Groups Form First Radiology Consortium
Thirteen practice groups representing more than 750 radiologists recently formed the first consortium of radiology practices, known as Strategic Radiology. The new consortium will focus on issues including how best to handle overnight radiology and quality assurance. It will also negotiate for a common medical liability carrier to find ways to collectively save money, according to Dr. Arl Van Moore, chairman of Strategic Radiology and president of Charlotte Radiology. Additionally, the consortium will look at common billing platforms in order to determine if there is one that can be used by all 13 practices in order to reduce costs. However, it will not negotiate collectively with insurance companies or share workloads at this time.
From "Private Practice Groups Form First Radiology Consortium"
Diagnostic Imaging (02/24/10) Moan, Rebekah
Radiation Errors Reported in Missouri
A Missouri hospital recently announced that it overradiated 76 patients, mostly brain cancer patients, over a five-year period due to powerful new radiation equipment that was improperly set up even though a representative of the manufacturer was watching the set-up process. CoxHealth hospital in Springfield announced that half of all patients undergoing a stereotactic radiation therapy were overdosed by about 50 percent after an unidentified medical physicist at the hospital miscalibrated the new equipment and routine checks over the subsequent five years failed to catch the mistake. Stereotactic therapy, which uses such high doses of radiation that usually only a single treatment is required, is commonly used to treat small tumors in the head. The error was discovered in September 2009 after a second physicist received training on the equipment, which was manufactured by BrainLAB. Missouri has little to no government oversight of radiation therapy. In a letter to the FDA, CoxHealth President and Chief Executive Robert Bezanson says that the FDA's recent decision to toughen oversight of diagnostic radiation does not go far enough, and that the initiative should be broadened to include regulation of medical radiation therapy.
From "Radiation Errors Reported in Missouri"
New York Times (02/24/10) Bogdanich, Walt
Survey Finds States Cutting Back on Mammograms
A poll by the Avon Foundation for Women of over 150 breast cancer health educators and providers from 48 U.S. states and Washington, D.C., has learned that 25 percent of the states are following controversial new screening guidelines from the U.S. Preventive Services Task Force, which recommends the reduction or cessation of routine mammograms and other early detection services for uninsured women under 50 years old. The survey rekindled worries that the guidelines might be used to refuse health coverage for women. Cancer doctors and advocacy organizations balked at the guidelines, warning that more women would die from breast cancer as a result. Lawmakers, meanwhile, said that the guidelines could be employed as an instrument to ration healthcare. Dr. James Thrall with the American College of Radiology's Board of Chancellors stated that "lawmakers at all levels need to act now to ensure that these recommendations do no further damage, and that women have full and ready access to mammography." Avon survey respondents from Alaska, California, Florida, Illinois, Michigan, Mississippi, Missouri, Nebraska, New York, and Washington, D.C., said they have witnessed revisions to breast and cervical cancer early detection programs in which screening mammography and other early detection services had been abbreviated or eliminated for low-income, uninsured, and underserved women younger than 50. The American College of Radiology advised lawmakers to officially proscribe the U.S. Preventive Services Task Force's recommendations from coverage decisions by federal and state insurance programs.
From "Survey Finds States Cutting Back on Mammograms"
Reuters (02/22/10) Steenhuysen, Julie
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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