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Featuring enhanced low-dose image quality with motion-free images, the Revolution Vibe CT system reportedly facilitates improved diagnostic clarity for patients with conditions ranging from in-stent restenosis to atrial fibrillation.

GE HealthCare Debuts AI-Powered Cardiac CT Device at ACC Conference

Through AI-powered assessment of coronary computed tomography angiography (CCTA) scans, the CaRi-Plaque software may provide improved clarity on the development of coronary plaques and luminal stenosis.

FDA Clears AI Software to Enhance CCTA Detection of Coronary Artery Disease

The Naeotom Alpha class of photon-counting computed tomography (PCCT) scanners emphasize significantly reduced scan times and enhanced detection of small abnormalities.

FDA Grants 510(k) Clearance for New Class of Photon-Counting CT Scanners

The use of ultra-high-resolution photon-counting CT in the evaluation of stable chest pain may significantly reduce follow-up tests and invasive coronary angiography (ICA) procedures, possibly resulting in millions in health-care cost savings, according to a cost-effectiveness analysis presented recently at the European Congress of Radiology.

New Analysis Forecasts Substantial Cost Savings with the Use of Photon Counting CT for CCTA

Ultra-high spatial resolution with photon-counting CT facilitated a 33 percent reduction in the assessment of median total plaque volume and a 45 percent higher inter-reader agreement for evaluation of low-attenuation plaque volume in contrast to energy-integrating detector (EID) CT.

Study Examines Potential of Ultra-High Spatial Resolution Photon-Counting CT for Coronary Plaque Quantification

While single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is well validated for the detection of coronary artery disease (CAD) and other cardiovascular abnormalities, there is a degrading effect with attenuation that requires an additional computed tomography (CT) scan to address attenuation compensation.

However, in a recent interview, Abhinav Kumar Jha, Ph.D, noted there are a large number of SPECT scanners that do not have the CT component and this issue is particularly prevalent in community hospitals and rural facilities. Dr. Jha says this problem is compounded as studies have demonstrated a higher prevalence of heart disease in rural health-care settings.

Dr. Jha pointed out that 75 percent of SPECT MPI exams are performed without attenuation compensation and cites a survey of nuclear cardiology providers that found only 5.6 percent provided CT-based attenuation correction.

“Therefore, you can imagine there's a very important need for a large segment of the patient population to have access to this technology of attenuation correction without being able to take a CT scan,” noted Dr. Jha, an associate professor of biomedical engineering and radiology at the Washington University School of Medicine in St. Louis.

However, in recently published research, Dr. Jha and other researchers developed a deep learning technique that provides CT-less (dubbed CTLESS) attenuation compensation. With this research and other studies, Dr. Jha said the CTLESS approach has provided consistent performance across scanner models and patients with different degrees of heart disease.

While acknowledging that more studies are needed to validate the technology, Dr. Jha noted the CTLESS approach has potential to bolster access to SPECT MPI.

“I'm excited about the CTLESS technology (and) making the process of attenuation compensation more accessible, affordable as well as safe,” emphasized Dr. Jha.

(Editor’s note: For related content, see “

Assessing MACE Risk in Women: Can an Emerging Model with SPECT MPI Imaging Have an Impact?

Radiology ‘Game-Changer’: FDA Approves PET Agent for Enhanced Detection of Coronary Artery Disease

Study Shows Merits of CTA-Derived Quantitative Flow Ratio in Predicting MACE

For more insights from Dr. Jha, watch the video below.

Abhinav K. Jha, Ph.D., discusses emerging research for a deep learning CT-less alternative for providing attenuation compensation for SPECT MPI.

Can Deep Learning Provide a CT-Less Alternative for Attenuation Compensation with SPECT MPI?

In a recent interview, Abhinav K. Jha, Ph.D., discussed key challenges with the use of SPECT MRI and how an emerging deep learning model may facilitate attenuation compensation without the need for an additional computed tomography (CT) scan.

While Marfan syndrome is a clinical diagnosis, Alan C. Braverman, M.D., FACC, noted in a recent interview that radiologists play an “invaluable” role in facilitating early diagnosis of this genetic aortic condition.

“They can be the first to put the words into a clinician's mind that this condition that they're seeing on imaging could be something much more,” emphasized Dr. Braverman, the director of the Marfan Syndrome and Aortopathy Center at the Washington University School of Medicine in St. Louis, Mo.

“When there are combinations of findings — root aneurysm, tortuous arteries, mitral valve prolapse — when these features are seen on an imaging study, not just reporting them in diameters accurately, but also suggesting the possibility of something more, like Marfan syndrome or some genetic aortic condition when unexplained in a young person, in particular, can be so helpful to the clinician. It's invaluable.”

For patients with Marfan syndrome, Dr. Braverman emphasized complete assessment of the proximal aorta. Noting that an enlarged aortic root is common in this patient population, Dr. Braverman said the diameter of the aortic root generally exceeds 40 millimeters in younger male patients and 37 millimeters in younger female patients.

While these findings can be visualized very well on echocardiogram, cross-sectional imaging with computed tomography angiography (CTA) or magnetic resonance angiography (MRA) are recommended for initial diagnosis in adult patients and can aid in differentiating between Marfan syndrome and other conditions, such as Loeys-Dietz syndrome, noted Dr. Braverman, a professor of medicine and alumni endowed professor of cardiovascular diseases at the University of Washington School of Medicine.

Improving Adherence to Best Practices for Incidental Abdominal Aortic Aneurysms on CT and MRI

Emerging ECG-Based AI Screening Software for Aortic Valve Stenosis Gets FDA’s Breakthrough Device Designation

Cardiac Ultrasound Update: FDA Clears Software with 45 Automated Parameters for Echocardiographic Analysis

For more insights from Dr. Braverman, watch the video below.

Alan Braverman, MD, discusses the role of radiologists in facilitating the timely diagnosis of Marfan syndrome.

Pertinent Insights into the Imaging of Patients with Marfan Syndrome

Emphasizing the role of radiologists in facilitating timely diagnosis of Marfan syndrome, Alan Braverman, M.D. discussed the use of echocardiography, CT, and MRI in evaluating patients with this genetic aortic condition.

Is it time to revisit initial imaging recommendations in established guidelines for the assessment of chest pain?

For patients with stable chest pain and no prior diagnosis of coronary artery disease (CAD), initial coronary computed tomography angiography (CCTA) was associated with subsequent revascularization in 62 percent of cases in comparison to 31 percent for nuclear stress single photon emission computed tomography (SPECT) testing and 34 percent for no testing, according to a 786-patient study presented at the American College of Cardiology Cardiovascular Summit in Washington, D.C.

In a recent interview, Markus Scherer, M.D., said the study findings show that CCTA offers the most effective tool for evaluating patients with stable chest pain in the absence of a prior CAD diagnosis.

“(Opting for coronary CTA is) a more efficient and more direct pathway to answer the clinician’s question as to whether or not you have coronary artery disease as a cause of your symptoms … and (determining) how much you have is enough to justify taking it to the next level and going to the invasive laboratory,” noted Dr. Scherer, the director ofcardiac CT and structural heart imaging at Atrium Health-Sanger Heart and Vascular Institute in Charlotte, N.C.

Should Dual-Source CT be the New Standard for ER CCTA Assessment of Acute Chest Pain

Could Photon Counting Reduce Iodinated Contrast Media for CT Angiography?

In terms of cost-effectiveness, Dr. Scherer added that coronary CTA, in his clinical experience, typically costs less than the more commonly performed nuclear stress SPECT test and is “certainly less” than direct referrals to the cath lab.

For more insights from Dr. Scherer, watch the video below.

Markus Scherer, M.D., discusses new research on coronary computed tomography angiography (CCTA) and revascularization rates in patients with stable chest pain.

Does Initial CCTA Provide the Best Assessment of Stable Chest Pain?

In a recent interview, Markus Scherer, M.D., discussed emerging research, presented at the American College of Cardiology Cardiovascular Summit, which showed that coronary computed tomography angiography (CTA) was associated with a significantly higher likelihood of revascularization in comparison to other modalities or direct referral for invasive coronary angiography.

For incidental pulmonary emboli (PE) findings on outpatient computed tomography (CT) scans, timely follow-up remains challenging due to daunting radiology worklists and potential health equity considerations, such as transportation access and language barriers, in high-risk populations.

However, in emerging pilot study research presented at the Society for Imaging Informatics in Medicine (SIIM) conference, Ali Tejani, M.D. discussed the implementation of an artificial intelligence (AI)-guided triage software for managing incidental PE findings on computed tomography (CT) scans.

Dr. Tejani and colleagues had impressive results with an approximately one-hour improvement in the median time to emergency department presentation and over a 13-hour difference in the median time to anticoagulant prescription retrieval.

Emerging AI Tool Improves Worklist Triage and CT Detection of Incidental Pulmonary Embolism

Can AI Improve Triage of CT Pulmonary Angiography Exams for Acute PE?

However, Dr. Tejani emphasized that these results wouldn’t have been possible without multidisciplinary collaboration in addressing previously existing challenges in the radiology workflow, including health equity considerations, that affect the quality of care. In collaboration with CT technologists, Dr. Tejani said they established a workflow requirement that patients with outpatient chest CT studies remain at the facility during AI assessment of the imaging. 

The combination of workflow changes with AI-enabled worklist reprioritization for radiologists led to more timely follow-up care for patients with incidental PE findings on CT scans, according to Dr. Tejani, a third-year radiology resident at the University of Texas Southwestern Medical Center.

“By instituting a clinical operations initiative that helps you leverage an AI result, (it) can actually translate to this clinically meaningful change,” noted Dr. Tejani.

For more insights from Dr. Tejani, watch the video below.

In a recent video interview from the Society for Imaging Informatics in Medicine (SIIM) conference, Ali Tejani, M.D., discussed pertinent insights on leveraging the value of adjunctive artificial intelligence (AI)-enabled triage software for computed tomography (CT) scans with radiology workflow improvements to achieve “clinically meaningful change” for patients with incidental pulmonary emboli findings.

Expediting the Management of Incidental Pulmonary Emboli on CT

The purchase of new and cutting-edge imaging equipment comes with a lot of excitement—and a learning curve. That's where Canon Medical Education comes in, providing a host of education solutions for clients that include both in-person and virtual training and continuing education opportunities.

The education arm of Canon Medical Systems USA provides a customizable plan to ensure that all imaging associates are well-trained and comfortable operating advanced equipment including MR and CT, as well as vascular and cath applications, among others. 

Understanding that every learner is different, Canon offers educational opportunities that include in-person, at their Institute of Advanced Imaging in Irvine, California; on-site training at a client facility; online and instructor-led courses in their Canon Learning Center; as well as CE and non-CE webinars and special programs.

To learn more about Canon's educational offerings, 

Canon Medical Systems offer a range of in-person and virtual educational opportunities for their clients. 

Education in Radiology: Canon's Customized Approach

Morris Panner didn’t want to call the familiar PACS system outdated or antiquated. However, he did suggest that radiology is on the cusp of a revolution with medical image and data management that parallels the ongoing emergence of the radiologist from the reading room to being a key member of the interdisciplinary team in facilitating optimal patient outcomes.

“The PACS system is no longer a new invention. It is important and you can always improve it but what people are really looking for now is how to free that data, take that pixel information, share it, use it with other types of data and advance the liquidity and flexibility in data management. That was the revolution that came out of the SIIM (Society for Imaging Informatics in Medicine) meeting this year,” noted Panner, the president of Intelerad Medical Systems, in a recent video interview.

recent survey research showing an increasing patient acceptance of artificial intelligence (AI)

, and the more gradual “try it” phase for many radiologists as they discern the most optimal fit for AI in their current workflows. To that end, Panner also reviewed key aspects of Intelerad’s Enterprise Imaging and Informatics Suite. It is Panner’s hope that by emphasizing improved efficiency and quality in radiology workflows, the system can “free up brain space for great diagnostics.”

For more insights from Morris Panner, watch the video below.

In a video interview, Morris Panner, the president of Intelerad Medical Systems, discussed key observations from the recent Society for Imaging Informatics in Medicine (SIIM) conference, recent research about artificial intelligence (AI) adoption and emerging goals for enhancing the efficiency of radiology workflows.

What's Next in Medical Image and Data Management in Radiology?

Is exposure to iodinated contrast media (ICM) a potential issue for young pediatric patients? The Food and Drug Administration (FDA) recently advised clinicians to ensure thyroid monitoring for patients three years of age and younger within three weeks after exposure to ICM. However, a 

recently published statement from the American College of Radiology (ACR)

 has raised questions about the FDA guidance.

In a recent video interview, Jonathan R. Dillman, M.D., MSc, who co-authored the ACR statement, noted 

several issues with the 11 studies the FDA used to support the guidance

In addition to a lack of prospective data and a lack of control groups in most of the studies cited by the FDA, the majority of the studies focused on high-risk pediatric patients such as low birth weight premature babies, neonates and those with congenital heart disease, according to Dr. Dillman, the associate chief of research in the Department of Radiology and the medical director of the Imaging Research Center within the Division of Radiology at the Cincinnati Children’s Hospital Medical Center.

Dr. Dillman said the FDA guidance is too broad and not supported by the current research.

“Wherever the science takes us, that is where we want to go. The science at this time we do not believe calls for universal thyroid monitoring after intravascular CT (computed tomography) in children three months of age and up. … There is really no evidence to support that,” maintained Dr. Dillman, who has served on the ACR’s Drugs and Contrast Committee since 2007.

For more insights from Dr. Dillman, watch the video below:

In a video interview, Jonathan Dillman, MD, MSc discussed a recently published statement from the American College of Radiology (ACR) that questioned the literature support for a March guidance from the Food and Drug Administration (FDA) about thyroid monitoring for children three years of age or younger within three weeks of exposure to iodinated contrast media (ICM).

Iodinated Contrast Media Exposure: Is Subsequent Thyroid Monitoring Warranted for Young Pediatric Patients?

The temporary shortage of iodinated contrast media (ICM) has been a huge issue in the radiology community, not to mention the overarching impact on the health-care field. While there is proverbial light at the end of the tunnel with the 

recent announcement from GE Healthcare about resuming full production of Omnipaque products

, Sean Bryant, M.D. said there are key takeaways that radiologists can utilize in the next couple of weeks as contrast supply begins to be restored and moving forward.

In a recent video interview, Dr. Bryant, the owner and president of Diversified Radiology, discussed the impact of the ICM shortage in the neuroradiology space. In addition to appropriate use of alternative imaging, such as substituting magnetic resonance imaging (MRI) or non-contrast computed tomography (CT) for contrast-enhanced CT scans, Dr. Bryant said the guidelines from the American College of Radiology (ACR) and the American Society of Health-System Pharmacists (ASHP) have been helpful in managing the ICM shortage.

Dr. Bryant said the ICM shortage also was an opportunity to reassess imaging protocols and educate patients as well as referring clinicians on alternatives to high contrast imaging. In emergency departments, oncology care and in-patient services in a hospital, Dr. Bryant noted that clinicians at times opt for high contrast without knowing the most optimal study to order for a given clinical scenario.

For additional insights from Dr. Bryant, watch the video below.

In a recent video interview on the current iodinated contrast media shortage, neuroradiologist Sean Bryant, MD discussed imaging alternatives, emphasized communication with referring physicians on optimal studies, and discussed the ongoing need to prevent “protocol creep” with timely updates of imaging protocols.

Lessons Learned from the Iodinated Contrast Media Shortage: A Neuroradiologist's Perspective

Perhaps the biggest challenge in radiology right now is the current global shortage of iodinated contrast media (ICM), which is most commonly utilized for computed tomography (CT) exams. With the temporary shortage expected to last until the end of June, radiology departments and larger medical facilities are scrambling to address this issue, which can have a significant impact on patient care.

With this in mind, we recently spoke with two professors from the Yale School of Medicine: Dr. Joseph Cavallo, an Assistant Professor of Radiology and Biomedical Imaging, and Dr. Jay Pahade, an Associate Professor and Vice-Chair of Quality and Safety for Radiology and Biomedical Imaging.

co-authored an article on strategies that imaging facilities may take to address this acute shortage of iodinated contrast media.

 They outline three central strategies including ICM dose reduction, utilization of alternative imaging modalities and possible deferment of imaging deemed to be non-urgent in nature.

Dr. Pahade called ICM a mission critical agent.

“Most institutions rely heavily on contrast-enhanced CT for the management of their patients both inside and outside of the emergency department (ED). Almost every critical diagnosis in medicine has some arm tied to CT imaging in one fashion or another,” emphasized Dr. Pahade.

For additional insights on the shortage of iodinated contrast media, watch the video below.

In a recent video interview, two radiology professors from the Yale School of Medicine discussed the impact of the iodinated contrast media (ICM) shortage and potential strategies, ranging from ICM dose reduction to possible deferment of non-urgent imaging, that may provide a viable path moving forward. 

Emerging Strategies for Managing the Acute Shortage of Iodinated Contrast Media

Not only do women have higher prevalence and mortality rates with ischemic heart disease (IHD) than men, they also have more atypical symptoms of the disease, according to researchers from the Beth Israel Deaconess Medical Center (BIDMC).

In a video interview, Diana Litmanovich, MD, chief of the cardiothoracic imaging section at BIDMC, and Rokas Liubauskas, a clinical research fellow in the radiology department of BIDMC, discussed their 

recent poster presentation at the American Roentgen Ray Society (ARRS) conference

, which focused on the impact of sex-based differences with risk factors, imaging, and the diagnostic workup of suspected IHD in women.

While diabetes mellitus and hypertension are well-established risk factors for myocardial infarction (MI), Dr. Liubauskas noted that they are higher risk factors in women than men. The authors also said that fewer women symptomatic for IHD present with typical symptoms such as chest pain. Common atypical symptoms in women who could have IHD may include nausea, vomiting and epigastric pain. Other complaints in women with possible IHD may include dyspnea, jaw pain, loss of appetite or lightheadedness.

When assessing women for potential coronary artery disease (CAD), Dr. Litmanovich explained that clinical predictive factors are reliable but less reliable in women compared to men. However, she maintained that predictability of an acute coronary event in women via imaging is better than that of men.

There are also key differences with imaging findings in this patient population. They pointed out that the smaller coronary artery diameter in women plays a key role with interpretation of imaging. Drs. Litmanovich and Liubauskas also discussed a lack of flow-limiting stenosis in over 50 percent of women symptomatic for IHD.

Other considerations impact the use of imaging devices for women with suspected IHD. While coronary computed tomography angiography (CCTA) has been recognized for its ability to help stratify risk in patients with CAD, the use of some medications to mitigate anxiety-related tachycardia in women may warrant heart rate monitoring, according to Dr. Liubauskas. When microvascular dysfunction is part of the equation for cardiac ischemia, Dr. Liubauskas says this requires functional tests for diagnosis.

When it comes to CAD, Dr. Litmanovich said women with preserved myocardium and ejection fraction may still have heart failure. In these cases, she said the use of magnetic resonance imaging (MRI) with delayed gadolinium enhancement may be warranted as “what looks normal on echocardiography or CT might actually correlate with abnormal MRI findings.”

For additional insights on the imaging and diagnosis of IHD in women, watch the video below:

Sharing insights from their recent presentation at the American Roentgen Ray Society (ARRS) conference in a new video interview, researchers discussed how sex-based differences have an impact in the imaging and diagnosis of ischemic heart disease (IHD) in women.

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