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  • Radiology in Public Focus

    December 01, 2013

    Press releases were sent to the medical news media for the following articles appearing in recent issues of Radiology.

    Whole-body MR images show multiple findings
    (Click to enlarge) Whole-body MR images show multiple findings in 74-year-old man with type 2 diabetes for 21 years. (A) Cardiac acquisitions in short-axis (top image) and four-chamber (middle image) views show impaired function with anterolateral hypokinesia (arrows). Late gadolinium-enhanced image (bottom image) shows enhancement of anterolateral myocardium (arrowhead) indicative of MI. (B) Cerebral acquisitions reveal normal cerebral arteries on time-of-flight angiogram (top image), axial T2-weighted brain image (middle image), and coronal fluid-attenuated inversion-recovery image (bottom image). (C) Vascular acquisitions on contrast-enhanced MR angiograms demonstrate 50 percent stenosis of left internal carotid artery (arrowhead) and multisegmental luminal irregularities of abdomen (upper arrow), thighs, and lower leg with severe atherosclerotic disease and vessel occlusion (lower arrow).
    Radiology 2013;269;3:730-737) ©RSNA, 2013. All rights reserved. Printed with permission. 

    Diabetes Mellitus: Long-term Prognostic Value of Whole-Body MR Imaging for the Occurrence of Cardiac and Cerebrovascular Events

    Cardiovascular disease as assessed with whole-body MR imaging confers strong prognostic information in patients with diabetes mellitus (DM), according to new research.

    Fabian Bamberg, M.D., Ph.D., of Ludwig Maximilians University, Munich, Germany, and colleagues studied the predictive value of whole-body MR imaging for the occurrence of a major adverse cardiac and cerebrovascular event (MACCE) in 65 patients with diabetes. The patients underwent a contrast-enhanced whole-body MR imaging protocol, including brain, cardiac and vascular sequences. Researchers then conducted follow-up inquiries to assess the rate of MACCE in the study group.

    Follow-up was completed in 61 patients. After a median of 5.8 years, 14 patients experienced MACCE. Patients who had detectable vascular changes on whole-body MR imaging faced a cumulative MACCE risk rate of 20 percent at three years and 35 percent at six years. None of the patients with a normal whole-body MR imaging went on to experience MACCE.

    “The extent of cardiovascular disease as detected with whole-body MR imaging in patients with diabetes mellitus (DM) has strong prognostic implications, independent of other established clinical or laboratory markers,” the authors write.

    Scatterplot depicts relative distance (miles) between clinic locations
    (Click to enlarge) Scatterplot depicts relative distance (miles) between clinic locations of FI-group (circles) and NFI-group (crosses) referring clinicians.
    (Radiology 2013;269;3:810-815) ©RSNA, 2013. All rights reserved. Printed with permission. 

    Physician Self-Referral: Frequency of Negative Findings at MR Imaging of the Knee as a Marker of Appropriate Utilization

    MR images of the knee from patients self-referred by clini­cians who owned MR equipment are more likely to be neg­ative than those from patients referred by clinicians without financial interest in the MR equipment, new research shows.

    Matthew P. Lungren, M.D., of Duke University Medical Center, Durham, N.C., conducted a retrospective review of con­secutive diagnostic MR images of the knee interpreted by one radiology practice between January and April 2009. The study comprised patients who had been referred by two separate physi­cian groups serving the same geographic community: one with financial interest (FI) in the MR imaging equipment used and one with no financial interest (NFI) in the MR imaging equip­ment used.

    Of 700 examinations, 205 had negative results (117 of 350 in the FI group and 88 of 350 in the NFI group, P = .016), a 33 percent increase in the frequency of studies with negative findings in patients re­ferred by the physician group that owns the MR imaging equipment. Among examinations with positive results, the mean total number of positive abnormality subtypes per image did not significantly differ between groups: 1.52 for the FI group and 1.53 for the NFI group (P = .96).

    “These findings suggest that there is a different threshold for ordering MR im­aging examinations, which may be due to financial incentive,” the authors write.

    Mediolateral oblique mammographic view demonstrates the BI-RADS breast density category, heterogeneously dense
    (Click to enlarge) Mediolateral oblique mammographic view demonstrates the BI-RADS breast density category, heterogeneously dense, which may obscure detection of small masses. The other BI-RADS breast density categories are almost entirely fatty, scattered fibroglandular density and extremely dense, which lowers the sensitivity of mammography.
    (Radiology 2013;269;3:887–892:) ©RSNA, 2013. All rights reserved. Printed with permission. 

    The California Breast Density Information Group: A Collaborative Response to the Issues of Breast Density, Breast Cancer Risk, and Breast Density Notification Legislation

    Statewide col­laborations like the California Breast Density Information Group (CBDIG) can assist in developing broad-scope guidelines and educational materials to help navigate challenges posed by breast density notification laws, according to a special report.

    In California, legislation requiring notification of women with heterogeneously and extremely dense breast tissue took effect April 1, 2013. Elissa R. Price, M.D., of the University of California, San Francisco, and CBDIG colleagues identified key elements and implications of the law, researching scientific evidence needed to develop a robust response. The group developed educational materials for referring physicians and patients and constructed an easily accessible website containing information about breast density, breast cancer risk assessment and supplementary imaging.

    In this era of patient-centered care and personalized medicine, breast density notification legislation provides an opportunity for radiologists to engage with referring clinicians and patients, the report states.

    “The multi-in­stitutional, multidisciplinary CBDIG approach may be a method for organi­zations to frame responses to individ­ual state laws as similar legislation is passed across the United States,” the authors write.

    See a feature article further examining what new breast density legislation means for radiologists and patients here. 

    Media Coverage of RSNA

    In September, 833 RSNA-related news stories were tracked in the media. These stories reached an estimated 240 million people. Coverage included U.S. News & World Report—Online, Yahoo! Health, MSN Health, Examiner.com, WABC-TV (New York), KCAL-TV (Los Angeles), WBBM-TV (Chicago), Science Daily and Health.com.

    Read coverage of RSNA in these media:

    RadiologyInfo.org Debuts New Screening and Wellness Section

    RadiologyInfo.org, the RSNA-ACR public information website, is pleased to announce its new Screening and Wellness section designed to answer patient questions about and provide a better understanding of:

    • Screening exams
    • Who should consider screening and why?
    • How screening is performed
    • The benefits and risks of screening
    • What happens if something is detected?

    Screening topics now available include Lung Cancer, Breast Cancer and Colorectal Cancer. Other topics in the works include cardiac and carotid artery screening.

    December Public Information Outreach Activities Focus on MR Imaging

    In December, RSNA’s 60 Second Checkup radio program focuses on the potential of MR imaging to predict heart attack and stroke risk in people with diabetes.

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