MRI

Radiology and surgery have traditionally been quite separate disciplines, one the very essence of hands-off healthcare, the other unashamedly invasive. Advances in image-guided therapy are now blurring that distinction, according to Prof. Pablo Ros, a professor of radiology at the Hospital de Sant Pau, Autonomous University of Barcelona.

The U.S. Department of Justice and Federal Trade Commission are pressuring state governments to repeal Certificate of Need laws that have lingered as a way to control healthcare costs by regulating health facility establishment, expansion, and purchase of capital equipment, such as MRI technology and CT scanners.

A Duke University study has established that unenhanced 3T MR imaging can deliver the same diagnostic accuracy as contrast-enhanced 3T MR arthrography of the shoulder, but without the associated pain, radiation, and risk of adverse contrast reactions.

A study involving the imaging histories of more than 200 children with sensorineural hearing loss recommends MRI instead of CT for identifying soft-tissue defects associated with inner ear anomalies.

Potential candidates for accelerated partial breast irradiation may benefit from pretreatment MRI to ensure no cancer is missed, according to a study conducted by Boston-based researchers.

Prostate cancer imaging proponents are advising physicians to follow recent federal recommendations against prostate cancer screening for men over the age of 75, but they say more government attention to care standards could lead to improved diagnosis and treatment.

A survey of academic radiologists’ clinical productivity shows that workload continues to increase, in both exam volume and complexity. Academic department heads could use the survey data to help set staffing levels and evaluate the performance of individual radiologists.

A recent study at the Oregon Health and Science University in Portland has confirmed that 3T MRI improves on 1.5T MRI for detecting and characterizing structural brain abnormalities in patients with focal epilepsy.

Breast cancer is the most common malignancy in adult women. One woman in 11 will contract the disease during her lifetime. The primary goal of treatment is cure, through surgery either alone or in combination with radiotherapy and/or chemotherapy. Surgical management options include breast conservation, mastectomy, and palliative treatment.

Primary malignant musculoskeletal tumors are an inhomogeneous group of lesions originating from mesenchymal tissues. Soft-tissue sarcomas can derive from fatty tissue (liposarcoma), muscles (leiomyosarcoma, rhabdomyosarcoma), connective tissue (fibrosarcoma), blood vessels (angiosarcoma), and neurogenic tissue (malignant peripheral nerve sheath tumor, malignant schwannoma).

Office released a major report on the growth of Medicare Part B imaging services at the same time the Centers for Medicare and Medicaid Services issued sweeping rules that target self-referred imaging services.

MR neuroimaging research has found that cognitive processes relating to verbal fluency are compromised in people with insomnia despite the absence of a behavioral deficit. These specific brain function alterations can be reversed, however, through nonpharmacological treatment with six weeks of sleep therapy.

Although both gadobenate dimeglumine and gadodiamide are gadolinium-based agents, the former provides more conspicuous enhancement for imaging of brain lesions, according to results from an international multicenter trial. Findings could lead to further improvements in the management of these patients.

The attention of the medical imaging community looks set to turn to Seoul later in October, when the 12th Asian Oceanian Congress of Radiology will be held. This is the first time the congress has been staged in Korea since its debut event in 1971, and, given the high quality of radiological practice within the country and its strong educational links with the U.S., the conference is bound to attract plenty of interest. The number and expertise of the invited speakers from North America are certainly impressive.

A novel MRI technique that tracks naturally occurring polymers in cartilage can lead to the diagnosis of early-stage osteoarthritis and may lead to better drug treatment and a reduction in the need for joint replacement surgeries.

Susceptibility-weighted MR imaging provides high-resolution, distortion-free blood oxygen level-dependent data for assessment of cerebral veins, blood products, and brain lesions. Currently, however, reconstruction of susceptibility-weighted imaging data is not implemented on all MR systems.

With piles of accumulated evidence demonstrating the ability of multislice CT to diagnose coronary artery disease, researchers are expanding clinical application of the modality to the measurement of myocardial viability following infarction.

Coronary heart disease is one of the leading causes of morbidity and mortality in developed countries.1 Accurate detection of early cardiac disease is of utmost importance for the delivery of appropriate treatment.

The era of postautopsy confirmation of Alzheimer’s disease may be coming to an end. MR imaging could spot signs of brain deterioration predictive of cognitive decline months, even years, before the onset of dementia, according to recent studies performed in Canada, Europe, and the U.S.

Multislice CT angiography should be the preferred choice over MR angiography or duplex ultrasound for initial evaluation of patients with suspected peripheral arterial disease.

Multislice CT is just as accurate as MRI in assessing myocardial infarct size in an emergency setting, according to a recent study conducted by researchers in France and the U.S. The latest data validate previous findings suggesting delayed-enhancement myocardial CT correlates well with measures of infarction size done with cardiac MR.

MR imaging can be used for many applications in oncology. Its main roles in cancer imaging are determining locoregional tumor extent, characterizing tumors, and monitoring treatment. MRI, like CT, relies on morphological criteria for lesion differentiation. This reliance, however, can make it difficult to detect small cancerous deposits and to differentiate tumor recurrence from treatment-induced tissue changes.

This month's cover story ("MR elastography inspires new wave of hepatic imaging," page 20) is devoted to a rare event: the birth of a new imaging modality. MR elastography is a wonder of human ingenuity that employs MRI, a modality that itself still seems like a miracle.

The International Society for Magnetic Resonance in Medicine is geared toward the eggheads of MR: the knob twisters who squeeze as much from their clinical scanners as they can, the experimentalists who push the limits of ultrahigh-field imaging.

Pro-radiology forces are claiming mandated Medicare accreditation as a victory. They will have to wait until January 2012, however, to see the actual implementation of federal law passed in July to mandate accreditation for high-tech medical imaging covered by outpatient Medicare.

In uncertain economic times, there is always one sure thing. Prices are more likely to fall than rise.

No clear winner has emerged in a head-to-head comparison of whole-body FDG-PET/CT and whole-body 3T MRI for non-small cell lung cancer staging. Unenhanced PET/CT proved better for detecting metastatic lymph nodes and soft-tissue involvement, while MR was more sensitive to the presence of brain and liver metastases.

Studies from Korea and the U.S. show that MR imaging of the knee is a reliable and accurate test for the detection of specific subtypes of medial meniscal tears. Good understanding of MR-depicted anatomic features helps identify false-positive injuries of the menisci and avoid unnecessary surgeries.

The U.S. Department of Veterans Affairs has awarded a three-year contract to the American College of Radiology to serve as the accrediting organization for 33 VA hospital radiation oncology facilities across the country.

A metastudy by Australian and European researchers indicates that MR staging identifies additional disease in nearly one of five women previously diagnosed with breast cancer. It also suggests that women may undergo more extensive surgeries than originally planned because of false-positive MR findings.