CT

From 1998 to 2007, the use of CT or MRI scans in emergency departments for injury-related conditions increased about three-fold without a similar increase in the prevalence of the diagnosis of certain life-threatening trauma-related conditions, according to a study in the October 6 issue of The Journal of the American Medical Association.

It's been a mere eight years since the blurry spots called ground glass opacities (GGOs) that appeared on spiral CTs were first linked to cancer. Already, the first hints are emerging of what they may actually mean to malignant transformation.

NYU will hold its first annual Dual-Energy CT Symposium Oct. 9-10 in New York City. The program is designed for radiologists who have or are considering acquiring a dual-energy scanner, research scientists who are looking to understand current uses of dual-energy CT to stimulate development of translational research projects, and technologists who need a basis in dual-energy terminology and concepts.

The American Academy of Neurology’s new guidelines on using MRI for stroke may represent best practice, but practical issues remain, interviews with several experts revealed.

Almost a quarter of all patients in a recent study who underwent CT angiography had findings outside the heart and great vessels, leading to several serious diagnoses being missed.

Most patients who have been offered colorectal cancer screening but turned it down are willing to undergo CT colonography as long as out-of-pocket fees are reasonable, according to a study.

A growing body of evidence supports the use of CT colonography for colon cancer screening and a U.S. panel should reverse its decision to not endorse the procedure, according to the CT Colonography Coalition.

The scanner could be brand new, but there is a good chance it’s operating with old protocols imported from a previous unit and not optimized for best imaging at the reduced dose levels possible today, a researcher suggests.

Radiation in any form brings risk. Medical radiation as a screening, diagnostic or treatment tool is designed with safeguards in mind to minimize the risk and maximize the benefit of the test or treatment. For instance, if a patient presents with a breast lump that can be felt but not viewed with mammography or ultrasound, medical professionals must employ the most appropriate diagnostic tools that identify potential cancer.

Some nuclear-based breast imaging exams may increase a woman’s risk of developing radiation-induced cancer, according to a special report appearing online and in the October issue of Radiology. However, the radiation dose and risk from mammography are very low.

To paraphrase Harry Truman, what virtual colonoscopy needs is a one-handed analyst. This was made clear earlier this week in the share price activity of iCAD , which leaped about 18% on news that the FDA had cleared the company’s VeraLook software for interpreting virtual colonoscopy exams. The next day the stock gave back about as much ground as it had gained.

An addiction treatment and rehab center in Florida has become the first facility on the East Coast to use single-photon emission CT scans as part of its standard of care for treating addicts. The Hanley Center in West Palm Beach is using the modality to analyze the parts of the brain affected by addiction in order to customize treatment for patients.

The CT marketplace in the U.S. is teetering on the edge of somnolence, a smoky gray purgatory stirred by a wafting hope of redemption but stalled in melancholy. CT has slipped into this netherworld following the manic adoption of 64-slice scanners, which has saturated the U.S. installed base with CT functionality that can meet all routine -- and some extraordinary -- clinical needs.

Although most hernias involving the anterior abdominal wall or groin can be diagnosed easily by inspection and palpation, imaging is the principal means of detecting internal, diaphragmatic, and other nonpalpable or unsuspected hernias.1,2

PET/CT scans can confirm a suspected colorectal cancer recurrence at an early stage, helping significantly in treatment, according to a study presented at the ARRS annual meeting.

PET/CT imaging with FDG can identify when a tear in the wall of the aorta causes blood to flow between the wall's layers and forces the layers apart, according to research.

In the wake of the slice wars, which saw CT scanners boom from four to 320 slices, a new battle will be fought, one focused on energy and spectral imaging. Photon counting, triple- and quad-energy systems, and a new breed of contrast agents are emerging drivers in the development of spectral CT, say some experts in topics scheduled for the Tuesday, May 18, ISCT session on Dual Energy and Spectral Imaging.

A dramatic shift in R&D toward patient safety has taken place in the CT industry, a shift most clearly seen in efforts to reduce patient radiation dose. Iterative reconstruction algorithms are a prominent fixture at the ISCT meeting this year, as they and their future development are increasingly seen as providing the means to cut dose, while maintaining or even boosting image quality.

Fears that revenues last year from the sale of new CTs in the U.S. would slide to levels not seen in a long time proved to be well founded, as the industry suffered its worst year in more than a decade.

The laws of physics cannot be broken-but they can be bent.

Much is known about dose reduction and adult patients, but what about kids? The literature is scant, but that doesn’t mean solutions don’t exist, according to a presenter at the International Society for Computed Tomography conference May 21.

Radiologists have come to expect rising demand for CT, which is why anecdotal reports of sudden and dramatic falls in CT volumes have sent a shudder through the community. All the more alarming is that the rumored drop-offs are coming at the request of patients who want nothing to do with CT because they fear its radiation will someday cause cancer. Instead they reportedly are demanding ultrasound or MRI because neither has ionizing radiation -- never mind that neither is indicated, nor, particularly in the case of ultrasound, has much chance of providing useful information.

Efforts to interconnect information systems raise the possibility that different experiences from multiple sites might be pooled and the practice of medicine made better through a kind of collective wisdom. At the ISCT symposium, Sandy Napel, Ph.D., a Stanford professor of radiology and codirector of the Radiology 3D Laboratory, examined how diagnoses made on some patients might help clarify whether the same diagnoses apply to others.

Iterative reconstruction algorithms will have a “profound effect” on CT as the enabling technology for advances in image quality and patient safety, said Stanford radiology professor Geoffrey Rubin at the ISCT symposium on multidetector row CT.

Clinical studies examining the potential of CT exposure to cause cancer are under way, but it could be years or even a decade until the results are known. Even then, they may be inconclusive, say expert presenters at the ISCT symposium on MDCT.

While most physicians rely on serum creatinine levels to determine kidney function, it’s not the most reliable indicator, according to a nephrologist who presented at the International Society for Computed Tomography on May 18. Instead, he suggested providers look at the estimated glomerular filtration rate (eGFR). In acutely ill patients in particular look at the changing serum creatinine (sCR) levels and not the specific values or specific eGFRs, he said.

GE Healthcare jumped ahead of competitors in the race to cut patient dose with the commercial release in 2008 of its Adaptive Statistical Iterative Reconstruction (ASIR), the first software to clean up CT images and, in the process, allow dramatic reductions -- up to 50% -- in patient radiation dose. In the first day of this year’s ISCT symposium, iterative reconstruction was hailed repeatedly as the leading solution to the hottest issue in CT patient safety.

TeraRecon’s “iNtuition Cloud” debuted as a commercially available product May 18 at the ISCT symposium. The newly available system is the company’s flagship iNutition solution in “Software as a Service” form.

While some may ask whether the CT community should transition to low kV, Willi A. Kalender, Ph.D., a professor in the Institute of Medical Physics at the University of Erlangen, in Germany, asks why not.

Three-D is all the buzz, as PACS companies struggle to include it in their products, if they haven’t already. But where this form of advanced visualization fits into the diagnostic process is still up in the air. Ironically, so are some of the everyday tools on which advanced visualization depends. Trust issues about the automation that makes sophisticated postprocessing viable are beginning to surface, just as progress in CAD offers new clinical capabilities.