H.A. Abella

Highlights of the 2008 RSNA meeting suggest the field of musculoskeletal radiology is moving away from purely descriptive imaging studies and more into quantitative ones. Research is advancing the understanding of tissue function and underlying anomalies as well as image-guided treatment options.

Pre-imaging intravenous hydration with sodium chloride remains the best prophylactic approach against contrast-induced nephropathy in patients with impaired renal function who must undergo coronary angiography, according to results from a large multicenter trial.

The Alliance for Radiation Safety in Pediatric Imaging is expanding the scope of its Image Gently awareness efforts. The move to protect patients from unnecessary exposure to imaging-related ionizing radiation includes the participation of CareCore National, a radiology benefits management company that will apply its guidelines to a member network of 28 million people.

Results from a large study by Italian investigators suggest that ultrasound can predict the risk of stroke in mostly asymptomatic patients based on the assessment of carotid artery plaque morphology, not just stenosis degree. Sonographic surveillance of plaque evolution could boost stroke prevention.

The patient was a married engineer and father of three. He presented to the emergency room with a global arterial circulation deficit, aphasia, and hemiplegia. An earlier noncontrast CT of the brain had found no signs of hemorrhage. An MR scan revealed a considerable perfusion defect caused by a carotid artery occlusion. He arrived 1.5 hours too late, however, for intravenous tissue plasminogen activator thrombolytic therapy.

This first Ultrasound Source journal review includes a head-to-head comparison between MRI and sonography in patients with sphincter defects and an interesting study with a large patient population proposing FAST scanning as a reliable selection tool for patients needing laparotomy. We also recommend a study evaluating two ultrasound imaging techniques for ablation guidance; a trial comparing sonography, MRI, and CT to define surgical margins in patients with chest wall tumors; and an interesting British study using 3D sonography to gauge abdominal aortic aneurysms.

Cryotherapy is often portrayed as radiofrequency ablation's little brother. But the thermal ablation technique is proving safer and more effective than previously thought, according to several papers presented at the RSNA meeting.

Those acquainted with Dr. Marc S. Levine could sum up his curriculum vitae with an inspiring statement: "unsung hero of double-contrast barium radiography." Affable and witty, Levine has led the gastrointestinal imaging section at the University of Pennsylvania Hospital since 1998 and topped last year by winning the Eminent Scientist of the Year Award from the International Research Promotion Council for helping to improve medicine in developing countries.

Increasing numbers of patients with vertebral compression fractures are being rushed to vertebroplasty, perhaps unnecessarily, say some interventional and musculoskeletal radiologists. While some specialists rejoice to see patients quickly relieved of their back pain, others warn that unnecessary procedures could become a burden for the healthcare system and patients.

Half of the people in the U.S. older than 50 could suffer fractures caused by osteoporosis over the next 13 years, according to a 2005 Surgeon General's report. Such ominous predictions move musculoskeletal conditions to the top of a long list of chronic diseases confronting baby boomers.

Radiologists face a choice between relinquishing control of ultrasound for good or reclaiming a modality that could thrive in their hands through the next decade. An indication of which way the specialty is leaning can be gleaned from an October seminar in which luminaries dissected practice trends and applications in use of ultrasound.

By combining microcoils with the injection of a foaming agent, U.S. interventional radiologists hope to treat testicular atrophy in young boys, reverse infertility in some men, and relieve a potentially disabling condition in women.

Although ultrasound contrast agents are not yet FDA-approved for use beyond the heart, they are already helping inspire careers in academic radiology.

Medical students may not need to wait for a residency or fellowship to gain experience with ultrasound. They could become familiar with the modality long before graduation, according to a study presented at the American Institute of Ultrasound in Medicine meeting in June.

Three-dimensional Doppler ultrasound can provide a quick, reliable diagnosis of carotid artery stenosis with just one sweep in real-time, according to a study presented Monday at the 2005 American Institute of Ultrasound in Medicine meeting.

Three-dimensional diagnostic ultrasound could be used for physiologic biometrics and positive individual identification, according to a study presented Monday at the AIUM meeting.

Researchers in Belgium have found that cooperation and consensus between radiologists and pathologists bolsters the diagnosis of musculoskeletal soft-tissue tumors when MR and histology results are contradictory.

The American College of Radiology has attacked a report prepared by a trade group representing cardiologists and other nonradiologists who interpret medical imaging, claiming the results misrepresent the real reasons for rapidly rising utilization.

A high-resolution ultrasound-based portable device will help physicians calculate bone loss in space travelers, according to researchers at NASA’s National Space Biomedical Research Institute. While focused on space-related health issues, NSBRI findings may translate into help for earth-bound patients with similar conditions.

Researchers in Germany believe that MR imaging should be included among the World Health Organization’s options for diagnosing sporadic Creutzfeldt-Jakob disease (sCJD), which is associated with exposure to mad cow disease.

Interventional radiologists can now kill two “birds” with just one probe. Simultaneous radio-frequency ablation of hepatic and pulmonary tumors is feasible, according to Italian researchers.

New data are refueling the drive for further utilization of MR imaging in the triage and characterization of breast cancer, according to studies presented Wednesday.

Interventional radiologists can now kill two “birds” with just one probe. Simultaneous radio-frequency ablation of hepatic and pulmonary tumors is feasible, according to Italian researchers.

Low-dose, whole-body CT not only provides a very sensitive diagnosis of osteolytic bone lesions, but it can also serve as an alternative to costly MR studies and replace time-consuming x-ray skeletal surveys, according to a presentation Tuesday.

Sonographic examination with microbubble contrast agents can reliably characterize focal liver lesions, confirm or exclude hepatocellular carcinomas, and remove the need for more invasive, costly imaging, according to studies presented Monday.

Using MSCT, an investigative team from Mount Desert Island Hospital in Bar Harbor, ME, confirmed that scurvy was to blame for the death of nearly half of 79 colonists who arrived on Saint Croix Island, ME, in 1604.

Abdominal MR angiography can now be performed in real-time, essentially eliminating digital subtraction angiography’s one remaining edge, according to a study published in the October issue of Magnetic Resonance in Medicine.

Endovascular stenting as the first treatment for patients with occluded iliac arteries found to be safe and cost-effective in a study comparing patients with primary stent placement and primary angioplasty followed by selective stent placement.