Submit Abstracts for RSNA 2012
Now is the time to submit your abstract to be considered for presentation at RSNA 2012. The submission deadline is 12:00 p.m. Central Time on March 31, 2012. Abstracts are required for scientific presentations, applied science exhibits, educational exhibits and quality storyboards.
To submit an abstract online, go to RSNA.org/abstracts.
More information about RSNA 2012, including registration and course enrollment dates, is available at RSNA2012.RSNA.org.
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Leading the News
Chemicals Used During Medical Imaging Tests May Damage Thyroid
New research suggests that iodinated contrast media, used to enhance medical images, may cause hyperthyroidism or hypothyroidism. These chemicals are often used in computed tomography scans and heart catheterizations. Senior author Steven Brunelli, director of dialysis services at Brigham and Women's Hospital in Boston, said in an interview: "[Patients] and their health care providers should be aware so that this could factor into discretionary testing and to undergo follow-up thyroid testing when appropriate." For the study, researchers looked at patients who were free of thyroid disease, checking for those who were exposed to iodinated contrast media. They found that 178 people developed hyperthyroidism, and, of those, 11 percent received contrast agents. The researchers also found that 213 people developed hypothyroidism and of those, 12 percent received contrast agents. Those who used contrast were 1.5 times more likely than those who didn't to develop hypothyroidism, a finding the researchers couldn't rule out was due to chance, Brunelli said. The study was published Jan. 23 in the Archives of Internal Medicine.
From "Chemicals Used During Medical Imaging Tests May Damage Thyroid"
Bloomberg (01/23/12)
Research
18F-flutemetamol PET Shows Promise for AD
18F-flutemetamol PET imaging may become a valuable tool in the study and diagnosis of Alzheimer disease (AD), according to an analysis of four studies presented at the 2012 Human Amyloid Imaging conference. Molecular imaging techniques that "visualize" amyloid in vivo are a major advancement in the study of AD, said lead author Dr. Juha O. Rinne, from the Turku University Hospital in Finland. Rinne and her colleagues examined the association between uptake of the amyloid PET imaging agent 18F-flutemetamol and the level of beta-amyloid in a frontal or parietal cortical region biopsy site. The study included 49 patients with suspected normal pressure hydrocephalus, either prospective or retrospective with 18F-flutemetamol PET and cortical brain biopsy during intracranial pressure measurement or ventriculo-peritoneal shunting. Researchers measured 18F-flutemetamol uptake with standardized uptake value ratio (SUVR). The 18F-flutemetamol SUVRs from the biopsy sites were significantly associated with biopsy specimen beta-amyloid levels using 4G8. Researchers also found a correlation between the biopsy specimen beta-amyloid level and uptake of 18F-flutemetamol in the region contralateral to the biopsy site. A visual assessment of images showed a high level of agreement between all readers.
From "18F-Flutemetamol PET Shows Promise for Alzheimer's Diagnosis"
Health Imaging (01/22/2012) Cadet, Justine
PET Tracer Shows Active Brains Have Less β-Amyloid
A study was performed to evaluate the association between lifestyle practices and β-amyloid deposition, quantified with positron emission tomography using carbon 11–labeled Pittsburgh Compound B ([11C]PiB), in healthy older individuals. The participants included a volunteer sample of 65 healthy older individuals, 10 Alzheimer disease (AD) patients, and 11 young controls studied from Oct. 31, 2005, to Feb. 22, 2011. Measurements were taken of the cortical [11C]PiB average and retrospective, self-report scales evaluating participation in cognitive activities and physical exercise. Lower [11C]PiB uptake was associated with more participation in cognitively stimulating activities across the lifespan but especially in early and middle life. Older participants in the highest cognitive activity tertile exhibited [11C]PiB uptake comparable to younger controls, while subjects in the lowest cognitive activity tertile exhibited [11C]PiB uptake comparable to AD patients. Greater cognitive activity was correlated with greater physical exercise, but exercise was not associated with [11C]PiB uptake. The researchers concluded that the tendency to engage in cognitively stimulating activities is likely related to engagement in various of lifestyle practices implicated in other studies demonstrating reduced risk of AD-related pathology. A direct association between cognitive activity and [11C]PiB uptake suggests that lifestyle variables identified in individuals with high cognitive engagement may prevent or retard deposition of β-amyloid, possibly influencing the onset and progression of AD.
From "Association of Lifetime Cognitive Engagement and Low β-Amyloid Deposition"
Archives of Neurology (01/12) Landau, Susan M.; Marks, Shawn M.; Mormino, Elizabeth C.; et al.
Heart Scans Have Modest Effect on Patient Care
A study was performed to investigate short-term cardiac catheterization rates and medication changes following noninvasive cardiac imaging. The study focused on a sample of 1,703 patients without a documented history of coronary artery disease and an intermediate to high probability of coronary artery disease undergoing cardiac single-photon emission computed tomography (CT), positron emission tomography (PET), or 64-slice coronary CT angiography. At 90 days, 9.6 percent of patients underwent catheterization. The rates of catheterization and medication changes increased in proportion to test abnormality findings. Among patients with the most severe test result findings, 38 percent to 61 percent were not referred to catheterization, 20 percent to 30 percent were not receiving aspirin, 35 percent to 44 percent were not receiving a beta-blocker, and 20 percent to 25 percent were not receiving a lipid-lowering agent at 90 days after the index test. Risk-adjusted analyses revealed that compared with stress single-photon emission computed tomography or positron emission tomography, changes in aspirin and lipid-lowering agent use was greater after computed tomography angiography, as was the 90-day catheterization referral rate in the setting of normal/nonobstructive and mildly abnormal test results. Risk-adjusted analyses determined that compared with stress single-photon emission CT or PET, shifts in aspirin and lipid-reducing agent use were greater following CT angiography, as was the 90-day catheterization referral rate in the setting of normal/nonobstructive and mildly abnormal test outcomes. The researchers note that the general impact of noninvasive testing on clinical management of patients referred for clinical testing was modest at best. The frequency of catheterization and medication change suggests that higher risk patients are possibly not receiving sufficient treatment.
From "Patient Management After Noninvasive Cardiac Imaging"
Journal of the American College of Cardiology (01/31/2012) Vol. 59, No. 5, P. 462 Hachamovitch, Rory; Nutter, Benjamin; Hlatky, Mark A.; et al.
Routine PET/CT Scan Use in Head and Neck Cancer Patients Can Detect Local Recurrences
Regular utilization of positron emission tomography/computed tomography (PET/CT) scans in head and neck cancer patient follow-up can identify local recurrences before they become clinically obvious and may improve the outcome of subsequent salvage therapy, according to a study reported at the Multidisciplinary Head and Neck Cancer Symposium. The study involved the review of 234 head and neck cancer cases treated with chemoradiation between 2006 and 2010 that also received a post-therapy PET/CT scan. The scans turned up 15 cases with abnormalities requiring further evaluation, and biopsies revealed malignancies in eight of the 15 cases; the other seven cases were false positives. All of the patients whose PET/CT scans were negative remained disease-free in subsequent follow-ups. "With malignancies found in 53 percent of abnormal scans in this study, our research proves that PET/CT scans are valuable as routine follow-up and as a surveillance method for head and neck cancer patients," said lead study author Yasir Rudha at St. John Hospital/Van elslander Cancer Center in Grosse Pointe Woods, Mich. "However, since the rate of false positives was 46 percent, caution should be shown when ordering biopsies after abnormal scans to prevent excessive unnecessary biopsies."
From "Routine PET/CT Scan Use in Head and Neck Cancer Patients Can Detect Local Recurrences"
Medical News (01/27/12)
Preoperative MRI May Help Manage Neurovascular Bundles in RALP
A study was held to ascertain whether findings at preoperative endorectal coil magnetic resonance (MR) imaging have an influence over the decision to preserve neurovascular bundles and the scope of surgical margins in robotic-assisted laparoscopic prostatectomy (RALP). A total of 104 male prostate cancer patients who underwent endorectal coil MR imaging of the prostate and subsequent RALP were assessed. MR imaging was executed at 1.5 T between January 2004 and April 2008 and included T2-weighted imaging, diffusion-weighted imaging, dynamic contrast-enhanced imaging, and MR spectroscopy. Imaging led to a change to the initial surgical plan in 27 percent of the patients, with the majority of the surgeries changed to a nerve-sparing technique. Furthermore, there were no positive margins on the side of the prostate where the surgical plan was changed to a nerve-sparing technique, potentially lowering the chance of postsurgical morbidity. The research was published online Jan. 24 in the journal Radiology.
From "Use of MR Imaging to Determine Preservation of the Neurovascular Bundles at Robotic-assisted Laparoscopic Prostatectomy"
Radiology (01/24/12) McClure, Timothy D.; Margolis, Daniel J.A.; Reiter, Robert E.; et al.
Medical-Legal Issues
AMA Chief Asks Boehner to Stop ICD-10
James Madara, executive vice president and CEO of the American Medical Association, has asked House Speaker John Boehner to stop the federally mandated implementation upgrade in October 2013 of the International Classification of Diseases 10th Revision of diagnostic and procedural codes "and to call on stakeholders to assess an appropriate replacement for ICD-9." Madara said the ICD-10 mandate "will create significant burdens on the practice of medicine with no direct benefit to individual patient care, and will compete with other costly transitions associated with the quality and health IT reporting program." He added that the timing of the transition "could not be worse as many physicians are currently spending significant time and resources implementing electronic health records into their practices."
From "AMA Chief Asks Boehner to Stop ICD-10"
Modern Healthcare (01/26/12) Conn, Joseph
How ready for ICD-10 is radiology? Read the December issue of RSNA News to find out.
Doc Groups: Shift Money to Scrap SGR
Physician organizations are asking Congress to use money that had been projected to be spent on the wars in Iraq and Afghanistan to pay for a permanent alternative to the sustainable growth-rate (SGR) formula used to calculate Medicare payments to doctors. Using excess baseline projections for Overseas Contingency Operations amounts to "cleaning the books" and will allow the elimination of a "flawed budget gimmick," physician organizations stated in a letter signed by 110 state medical associations and specialty societies. Unless Congress takes action, doctors will have their Medicare payment cut by 27.4 percent on March 1 under the current SGR formula. According to the letter, if the SGR had been repealed in 2005, the resulting cost would have been $48 billion; but now that cost is $290 billion "and growing rapidly."
From "Doc Groups: Shift Money to Scrap SGR"
Modern Physician (01/24/12) Robeznieks, Andis
Read what the experts have to say about radiology's survival in the new healthcare reform era, in the January issue of RSNA News.
Clinical Practice
Visual Nudge Improves Accuracy of Mammogram Readings
Researchers have developed a method to improve training in reading mammograms. A novice can be subtly guided to follow an expert's scanpath across a mammogram, improving accuracy. Subtle gaze direction works by using the difference between peripheral and central (foveal) vision. To direct the gaze, the researchers changed the brightness of an area in the peripheral field of view to draw the novice's focus. The idea is to get someone to look in a particular direction while altering their experience of viewing the image as little as possible. In the case of mammograms, you want to get a learner to look at the tumor region but you don't want to do anything that makes the tumor region look different than it does on the mammogram itself. For their study, the researchers used a database of mammogram images and hired an expert radiologist to view and mark 65 images while an eye-tracking system recorded the expert's scanpath. During the experiment, researchers used subtle gaze direction to guide a group of novices along the expert's scanpath, while a control group viewed the mammograms without guidance. Those who received subtle gaze direction were significantly more accurate than the control group, even after gaze manipulation was disabled. The researchers will present their experimental results in March at the Eye Tracking Research & Application Symposium.
From "Visual Nudge Improves Accuracy of Mammogram Readings"
PhysOrg.com (01/26/12)
Industry News
Bill Would Send Women More Mammogram Data
Utah Sen. Karen Mayne (D-West Valley City) has introduced a bill to encourage radiologists to include more data on the mammogram results they send to patients. If passed, SB32 would encourage radiologists in Utah to include information about a woman's breast density on the mammogram report. Currently, the test results only tell women whether or not cancer was detected. However, mammograms also detect dense tissue, a common condition. Although dense breast tissue is not harmful in and of itself, mammograms are less effective in detecting cancers if the woman has dense tissue. Recent research has found that dense tissue becomes less prevalent with age. SB32 would encourage clinics or hospitals that provide mammograms to notify patients of dense tissue, allowing the patient to consult with their doctors and decide whether followup tests are necessary. Women can currently find out about their breast density through their primary physician, who receives a detailed report of the mammogram. The bill has been amended to encourage, not mandate, the provision of tissue density information.
From "Bill Would Send Women More Mammogram Data"
Deseret News (UT) (01/25/12) Farmer, Molly
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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