Radiology in public focus

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

Long Spaceflights Affect Astronaut Brain Volume

Extended periods in space have long been known to cause vision problems in astronauts. A new study suggests that the impact of long-duration space travel is more far-reaching, potentially causing brain volume changes and pituitary gland deformation.

Study lead author Larry A. Kramer, MD, from the University of Texas Health Science Center at Houston and colleagues performed brain MRI on 11 astronauts, including 10 men and one woman, before they traveled to the International Space Station. The researchers followed up with MRI studies a day after the astronauts returned, and then at several intervals throughout the ensuing year.

MRI results showed that the long-duration microgravity exposure caused expansions in the astronauts’ combined brain and cerebrospinal fluid (CSF) volumes. The combined volumes remained elevated at one-year postflight, suggesting permanent alteration. MRI also showed alterations to the pituitary gland. Most of the astronauts had MRI evidence of pituitary gland deformation suggesting elevated intracranial pressure during spaceflight. The researchers also observed a postflight increase in volume, on average, in the astronauts’ lateral ventricles. However, the overall resulting volume would not be considered outside the range of healthy adults.

“If we can better understand the mechanisms that cause ventricles to enlarge in astronauts and develop suitable countermeasures, then maybe some of these discoveries could benefit patients with normal pressure hydrocephalus and other related conditions,” Dr. Kramer said.

Kramer

Reconstructed sagittal 5-mm orthogonal midline images in the brain using the sagittal three-dimensional T1weighted data set. (a) Preflight baseline image and (b) matching postflight image (postflight day 1) in the same astronaut. The black arrowheads show upward expansion of the anterior, middle, and posterior superior margins of the lateral ventricle with associated narrowing of the marginal sulcus of the cingulate sulcus (white arrowhead). There is subtle expansion of the third ventricle (indicated by a 3), which has displaced the thalamus (T) from midline, making it less visible. There is thickening of the intermediate signal scalp soft tissue (arrows).

Kramer et al, Radiology 2020 ©RSNA 2020

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Access the Radiology study, “Intracranial Effects of Microgravity: A Prospective Longitudinal MRI Study.”

3D Fusion Imaging Improves Coronary Artery Disease Diagnosis

A new technique that combines CT and MRI can bolster coronary artery disease diagnosis and help to define appropriate treatment for patients suffering from the disease.

CT and MRI are established methods for noninvasive cardiac imaging and evaluation of coronary artery disease. Despite their complementary strengths, CT and MRI findings are often analyzed separately, limiting the ability to fully leverage the strengths of the two methods.

Study lead author, Jochen von Spiczak, MD, MSc, University Hospital Zurich in Zurich, Switzerland, and colleagues combined CT and MRI images and developed an approach that depicts all the available information from CT and cardiac MRI in one 3D image.

They compared their approach with conventional 2D readouts in 17 patients who underwent cardiac CT and cardiac MRI due to suspected or known coronary artery disease. Conventional 2D readout of the images resulted in uncertain findings in eight cases. The new approach helped solve the divergent findings in six of those cases.

Information from the 3D fused image helped correlate specific stenoses, or areas of narrowing in the coronary arteries, and their severity with possible cardiac scar tissue and ischemia. This could be used to help guide interventional or surgical revascularization procedures like stenting or bypass surgery.

“The technique may allow for an easier and possibly more accurate identification of patients and coronary stenoses that are likely to benefit from revascularization,” Dr. von Spiczak said. “Applying today’s clinical 2D standard led to a substantial number of uncertain findings in our study, whereas most of these divergent findings could be solved when including additional information from CT-derived blood flow estimates information and 3D image fusion.”

von Spiczak

Images of a 65-year-old man (patient 6). (a) Cardiac MRI perfusion shows perfusion deficit of anterior/anterolateral wall attributed to left anterior descending artery/left circumflex artery (*). (b) CT coronary angiography. (c) Coronary angiography, left anterior oblique projection with caudal angulation. (d) Three-dimensional image fusion helped refine diagnosis: perfusion deficits (*) were most likely caused by narrow first diagonal branch and its first, stented side branch (arrowhead). Retrospectively, denoted lesion could also be found at CT coronary angiography and coronary angiography (arrowheads in b and c, respectively). CT FFR = CT-derived fractional flow reserve, LGE

von Spiczak et al, Radiology 2020 ©RSNA 2020

New Articles Reveal COVID-19 Impact on Radiology

New articles published in Radiology and Radiology: Imaging Cancer shine a light on the effects of COVID-19 on radiology practice and research throughout the United States and reveal that outpatient facilities will be hardest hit.

The COVID-19 pandemic has already had a profound impact on U.S. radiology practices. Measures adopted to slow the transmission of disease and expand crisis capacity are decreasing the demand for imaging independent of COVID-19.

“At a time of unprecedented public health and economic crisis, radiologists have never experienced so much uncertainty. We attempt to lay out the background and the path forward,” said Howard P. Forman, MD, MBA, from Yale School of Management and lead author of the special report, “The Economic Impact of the COVID-19 Pandemic on Radiology Practices.”

Cancer imaging has also been affected, and the necessary delay or rescheduling of cancer imaging procedures due to COVID-19 is expected to create a surge down the road that will tax the capacities of scanner time and medical personnel.

“We present challenges the cancer imaging community must overcome to restore clinical and research operations,” said Gary D. Luker, MD, from Michigan Medicine, University of Michigan, Editor of Radiology: Imaging Cancer and lead author of “Transitioning to a New Normal after COVID-19: Preparing to Get Back on Track for Cancer Imaging.”

The effects of the pandemic on radiology research are already visible, as U.S. universities have severely curtailed research activities since the pandemic exploded in March.

“The COVID-19 pandemic has disrupted research at all levels, and our manuscript highlights some of the experiences from academic medical centers while shutting down imaging research. More importantly, we also discuss the short term and long-term ramifications. These include funding challenges, hiring and retention of research personnel and impact on careers,” said Achala Vagal, MD, MS, from the University of Cincinnati Medical Center and lead author of “The Impact of the COVID-19 Pandemic on the Radiology Research Enterprise: Radiology Scientific Expert Panel.”

Media Coverage of RSNA

In March, 740 RSNA-related news stories were tracked in the media. These stories had over 605 million audience impressions.

 

Coverage included The Wall Street Journal, Newsweek, Fortune, Nature, U.S. News & World Report, ScienceDaily, Drugs.com, HealthDay, Medscape, Houston Chronicle, MedPage Today, Pittsburgh Post-Gazette, Auntminnie.com, Applied Radiology, Radiology Business, Diagnostic Imaging and Health Imaging News.

Professions in Radiology

Do you know someone interested in becoming a radiologist? Encourage them to visit the RadiologyInfo.orgWhat Does a Radiologist Do?” webpage to learn more about radiology specialties, radiologists’ role in health care and what it takes to become a radiologist.

Check out the Professions in Radiology page for diagnostic radiology, interventional radiology, nuclear medicine and radiation therapy career information.

New on RadiologyInfo.org

Visit RadiologyInfo.org, the public information website produced by RSNA and ACR, to read new patient safety information on Fetal and Gonadal Shielding.

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