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  • Journal Highlights

    The following are highlights from the current issues of RSNA’s two peer-reviewed journals.

    November 1, 2017

    Imaging Neoadjuvant Therapy Response in Breast Cancer

    Studies of neoadjuvant therapy for breast cancer have used a variety of methods for assessing tumor response. Currently, there are no established clinical practice guidelines for how best to assess tumor response to neoadjuvant therapy. Typically, patients undergo conventional breast imaging (mammography and ultrasonography) and physical examination.

    In an article published online in the October issue of Radiology(RSNA.org/Radiology), Amy M. Fowler, MD, PhD, University of Wisconsin School of Medicine and Public Health, Madison, WI, and colleagues present the advantages and limitations of current assessment methods and the functional and molecular imaging modalities being investigated as emerging techniques for evaluating neoadjuvant therapy response for patients with localized, nonmetastatic primary breast cancer.

    Current methods reviewed include physical examination, conventional breast imaging with mammography, contrast-enhanced MR imaging and US.

    Functional and molecular imaging techniques discussed include dynamic contrast enhanced perfusion MRI, diffusion weighted MRI, MR spectroscopy, 2-Deoxy-2-Fluoroglucose Positron Emission Tomography (PET) imaging, 3’-Deoxy-3’-Fluorothymidine PET imaging, imaging amino acid metabolism, C-choline PET imaging, and PET imaging of tumor blood flow and metabolism.

    Prospective, response-guided clinical trials are needed to demonstrate that the use of functional and molecular imaging to guide neoadjuvant therapy management improves patient outcomes before widespread clinical adoption can occur, the authors write.

    “We anticipate that advances in the field of radiogenomics, which links imaging phenotypes to tumor gene expression patterns, will help elucidate the most clinically useful imaging approach to assess neoadjuvant therapy response for breast cancer patients,” Dr. Fowler said. “Thus, an emerging paradigm of precision imaging is an important tool to fully realize the goal of precision medicine,” the authors write.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available online only.

    Central Nervous System Effects of Intrauterine Zika Virus Infection: A Pictorial Review

    Distinct imaging modalities may be used to better evaluate the different brain abnormalities associated with congenital Zika virus infection according to an online article in the October Special Issue of RadioGraphics, (RSNA.org/RadioGraphics).

    Bianca Guedes Ribeiro, MD, from the Clínica de Diagnóstico por Imagem, Rio de Janeiro, and colleagues discuss the prenatal and postnatal neurologic imaging findings of congenital Zika virus infection.

    Brain abnormalities related to Zika virus infection may be primarily observed with prenatal ultrasound (US), especially in the third trimester of pregnancy. Measurement of the head circumference is one of the main tools to detect microcephaly. Ultrasound is able to easily demonstrate abnormalities including brain calcifications, cerebral atrophy, posterior fossa and corpus callosum abnormalities, ventriculomegaly and to depict craniofacial disproportion and microphthalmia.

    Fetal MRI improves the identification of brain malformations such as cerebral atrophy, ventriculomegaly and microphthalmia and may be performed when abnormalities such as microcephaly and calcifications are depicted at fetal US.

    Transfontanellar US remains, in the authors’ opinions, the best first screening method to evaluate newborns exposed to the Zika virus. After birth, CT may also be performed to improve the evaluation of microcalcifications.

    “Because Zika virus infection is a new entity, the application of different imaging modalities, such as CT and MR imaging, to evaluate and follow up infected patients may uncover previously unknown information about the disease and its consequences,” the author write.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available online only.

    RSNA Journals Focus of RSNA 2017 Sessions

    “Publishing in Radiology: Understanding and Using the STARD and PRISMA Guidelines,” will be the focus of an RSNA 2017 session on Wednesday, Nov. 29.

    Radiology Editor Herbert Y. Kressel, MD, (pictured, right) will provide the introduction for a session focusing on the Standards for Reporting Diagnostic Accuracy (STARD) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for journal submissions. Dr. Kressel and other presents will discuss the importance of quality improvement initiatives in disseminating published research in journals such as Radiology.

    RadioGraphics Editor Jeffrey S. Klein, MD, will present, “Reviewing for RadioGraphics,” from 9 to 9:45 a.m., Sunday, Nov. 26. Dr. Klein will discuss how peer reviewers are chosen and evaluated and will review a RadioGraphics mentoring program for senior radiology residents and fellows.

    Add courses to My Agenda at Meeting.RSNA.org

    Learn about RSNA Journals at RSNA 2017

    Check out RSNA’s print, online and mobile publications and learn about unique online features at the Membership & Resources booth in the Connections Center at RSNA 2017. Staff will be available to assistant attendees with any journal-related customer service inquiries.

    Radiology Podcasts

    Radiology Podcasts
    Radiology Podcasts

    Listen to Radiology Editor Herbert Y. Kressel, MD, deputy editors and authors discuss the following articles in the September issue of Radiology at RSNA.org/Radiology-Podcasts.

    • “Detection of Clinically Significant Prostate Cancer: Short Dual–Pulse Sequence versus Standard Multiparametric MR Imaging — A Multireader Study,” Borna K. Barth, MD, and colleagues.
    • “Utilization Management of High-Cost Imaging in an Outpatient Setting in a Large
      Stable Patient and Provider Cohort over 7 Years,” Jeffrey B. Weilburg, MD.
    • “High-Intensity Focused Ultrasound for Treatment of Symptomatic Benign Thyroid
      Nodules: A Prospective Study,” Brian Hung-Hin Lang, MS.

    RadioGraphics Podcasts

    Radiology Podcasts

    Listen to RadioGraphics Editor Jeffrey S. Klein, MD, and authors discuss the following articles in recent issues of RadioGraphics at pubs.RSNA.org/RG-Podcasts.

    • “Central Nervous System Effects of Intrauterine Zika Virus Infection: A Pictorial Review,”
      Bianca Guedes Ribeiro, MD, and colleagues.
    • Clinical PET Imaging in Prostate Cancer,” Kathryn L. Wallitt, MBBS, BSc, and colleagues.
    • ““Decreasing Stroke Code to CT Time in Patients Presenting with Stroke Symptoms,”
      Aleksandrs Kalnins, MD, MBA, and colleagues.

    JH Radiology
    Images in a 57-year-old woman with newly diagnosed clinical stage IIA (T2N0M0) right breast cancer. Histologic results were grade 3, ER-negative, PR-negative, HER2-nonamplified invasive ductal carcinoma with extensive necrosis. Maximum intensity projection from contrast material–enhanced breast MRI performed prior to neoadjuvant chemotherapy demonstrates 3.3-cm irregular right breast mass with rim enhancement (arrow) and 1.8 cm of linear nonmass enhancement extending anterior to the mass (arrowhead).

    Arthrogryposis and microcephaly in a 37-week fetus with congenital Zika virus infection acquired in the first trimester of gestation of a 21-year-old mother. (a) Three-dimensional fetal reconstruction MR image shows joint contractures. (b) Sagittal T2-weighted MR image shows microcephaly with cortical atrophy, posterior fossa abnormalities with cerebellar hypoplasia, and absence of the vermis. A thin brainstem is also depicted. (RadioGraphics 2017); 37;6;1840–1850) © RSNA 2017. All rights reserved. Printed with permission.

    Kressel speech