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    August 01, 2013

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

    Hybrid PET/MR Imaging of the Heart: Feasibility and Initial Results

    Cardiac PET/MR imaging with fluorine 18 fluorodeoxyglucose (FDG)
    Acute occlusion of the left circumflex artery and a corresponding subendocardial infarction of the lateral and inferior myocardial wall in a 59-year-old male patient. PET data mapped onto a polar plot and overlaid with the 17-segment model of the left ventricle. Despite the subendocardial extent of the infarction, agreement between LGE and PET images was high in this patient. (Radiology 2013;268;2:366-373) ©RSNA, 2013. All rights reserved. Printed with permission.

    Cardiac PET/MR imaging with fluorine 18 fluorodeoxyglucose (FDG) is feasible and may add complementary information in patients with ischemic heart disease.

    In the August issue of Radiology (RSNA.org/Radiology), Felix Nensa, M.D., of University Hospital Essen, University of Duisburg-Essen, Germany, and colleagues studied 20 consecutive patients with myocardial infarction who underwent cardiac PET/MR imaging. Ten patients underwent additional cardiac PET/CT before PET/MR. Researchers performed 2D half-Fourier acquisition single-shot turbo spin-echo sequences, balanced steady-state free precession cine sequences, 2D turbo inversion-recovery magnitude T2-weighted sequences, and late gadolinium-enhanced (LGE) segmented 2D inversion-recovery turbo fast low-angle shot sequences. Categorical intermethod agreement between PET and cine imaging or LGE imaging, respectively, was calculated using the Cohen k.

    Cardiac PET/MR imaging was successfully performed in 19 of 20 patients. In 306 segments, 32 percent were rated as infarcted on PET images compared with 30 percent rated as infarcted on LGE images and 29 percent rated as infarcted on cine images. In the subgroup of patients with an additional PET/CT scan, no significant difference in myocardial tracer uptake between PET/CT and PET/MR images was found.

    “Our results demonstrated the feasibility of hybrid cardiac PET/MR imaging with FDG in myocardial infarction on an integrated wholebody PET/MR imaging system with 3-T field strength,” the authors write. “Yet, it must be proved that this new hybrid imaging modality yields added value of clinical relevance.”

    Interactive Case Review of Radiologic and Pathologic Findings from Breast Biopsy: Are They Concordant? How Do I Manage the Results?

    Radiologic and Pathologic Findings from Breast Biopsy
    Ultrasound image shows a complex mass in the left breast of a 37-year-old woman with a bloody nipple discharge and palpable left breast mass. (RadioGraphics 2013;33:E149-E152) ©RSNA, 2013. All rights reserved. Printed with permission.

    As percutaneous breast biopsy becomes more common and supplants excisional biopsy as the preferred diagnostic tool, the radiologist’s role in caring for patients must extend beyond imaging to include identifying lesions for biopsy and performing the procedure.

    To successfully perform a minimally invasive breast biopsy, radiologists must not only be familiar with the technique, but know how to determine radiologic-pathologic concordance as well as the appropriate treatments for patients after the procedure.

    In an online-only article in the July-August issue of RadioGraphics (RSNA.org/RadioGraphics), Christopher P. Ho, M.D., of the University of Virginia Health System, Charlottesville, Va., and colleagues use a case-based system to review the radiologic-pathologic correlation of breast lesions and appropriate BI-RADS lexicon and classification and discuss concordance and case management.

    An accompanying online tutorial presents typical diagnostic cases and allows users to participate in all stages of case management.

    “The decision to recommend surgical excision or short-term follow-up relies heavily on whether the histologic diagnosis correlates with the imaging findings, a determination that is part of the radiologist’s responsibilities if he or she performs the biopsy,” according to the authors.

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