MRI

Determining the safety of MRI for patients who are implanted with hemodynamic monitoring or temporary pacing devices, including epicardial pacing wires and intracardiac pacing leads, requires careful consideration.

Inspired by vertebroplasty's success, researchers have shown that percutaneous cement injections can also successfully stabilize arthritic and neoplastic lesions affecting the femoral head. The technique offers pain relief and an alternative to surgery for selected patients.

New CT perfusion scanning techniques that are safer and faster than older CT protocols could offer a practical imaging alternative to MR perfusion for stroke patients, according to two studies presented at the 2007 RSNA meeting. Findings also emphasize a new trend for widening the window for thrombolysis.

he explosive growth of Medicare outpatient imaging from 2000 to 2005 explains why federal regulators have singled out radiologists for restraints. Medicare payments for outpatient medical imaging jumped 93% during that period, from $6 billion to more than $11 billion.

The massive American College of Radiology Imaging Network 6666 trial shows that adding ultrasound to the initial breast screening protocol for high-risk women could help detect 30% more cancers, but at the questionable cost of many more needless biopsies of benign lesions.

Prostate cancer imaging experts sent out a clear message in 2007: Prostate cancer in the U.S. has become an unrecognized patient care crisis that needs tackling. The good news is these experts agree that advanced imaging technologies could help in early detection and minimally invasive treatment. The lack of a cohesive national strategy is worrisome, however, and they want to see the adoption of a broad initiative for diagnosing and treating prostate cancer similar to that for breast cancer.

German researchers were stunned to discover that whole-body staging of patients with recently diagnosed malignancies using either MRI or PET/CT could miss a substantial number of metastatic lesions. They released their data at the 2007 RSNA meeting.

Use of dynamic contrast-enhanced MRI to evaluate the breast is rapidly increasing despite the lack of established standards or clearly defined indications and limited randomized clinical trials. The superior sensitivity of MRI for invasive breast cancer has led to the proliferation of its use. Its variable specificity, however, has limited its utility.

Researchers used a customized search engine to quickly find that most discordant resident versus attending physician preliminary reports involved fractures, liver/kidney lesions, pulmonary nodules, and gastrointestinal wall thickening.

All has been relatively quiet on the nephrogenic systemic fibrosis news front lately, allowing time for reflection and hope in the New Year that gadolinium’s safety image can be reestablished with solid screening protocols to protect the small number of patients at risk.

Investigators begin recruiting the first of 7300 volunteers this month for a massive clinical trial to determine if a combination of blood tests, body measurements, and imaging exam can outperform the Framingham tests for assessing older adults who carry an intermediate risk of a major cardiovascular event, including myocardial infarction and stroke.

Can functional MRI detect the anatomic point of origin of belief in a personal God? That profound physiological and philosophical question has been answered in the affirmative by Mark S. Cohen, Ph.D., and colleagues at the University of California, Los Angeles Center for Cognitive Neuroscience and the UCLA Brain Mapping Center.

Research studies published in November and December demonstrate there are no one-stop radiologic shops for the diagnosis of cardiovascular disease. Each modality is endowed with specific strengths that recommend it as the instrument of choice in specific clinical situations.

HIV-positive patients could benefit from the ability of MR diffusion tensor imaging to reveal microscopic changes in their spinal cords before abnormalities show up on conventional MR imaging. The early warning could identify those who would benefit from antiretroviral therapy.

In an unlikely gathering, representatives of medical imaging and petroleum industries met Nov. 12 at the University of Houston to explore common mechanical problems associated with moving blood and oil through vessels and pipelines.

Radiologists who wonder why diagnostic imaging has been targeted for utilization constraints need only examine the Medicare B experience from 2000 to 2005. Medicare payments for outpatient medical imaging rose 93% during that period from $6 billion to more than $11 billion. The increase reflected a shift in preference to high-cost, high-tech modalities, especially CT and MR. Utilization among cardiologists exploded.

A 14-year-old female patient presented for evaluation of a right foot mass. She stated that she was generally asymptomatic but would occasionally experience significant discomfort if she bumped her foot. Physical examination revealed fullness to the lateral aspect of the foot, which was concerning for bony expansion of the fifth metatarsal. No point tenderness, overlying skin lesions, or neurological deficits within the foot were noted. Multiple imaging modalities were carried out for further evaluation.

Breast MRI has been available for over a decade. It is only now, however, that the examination is becoming recognized as an indispensable adjunct to mammography and ultrasound. Several key factors contribute to this acceptance of clinical breast MRI.

The 0.6T Fonar Upright MRI is not in the same class as 3T scanners, but it features capabilities superconducting technologies can't match. High-field imaging is performed with the patient relaxed in a supine position. Upright imaging is conducted while the patient sits, stands, or flexes in a weight-bearing position to duplicate the conditions that cause his or her pain.

Radiologists who wonder why diagnostic imaging has been targeted for utilization constraints need only examine the Medicare B experience from 2000 to 2005. Medicare payments for outpatient medical imaging rose 93% during that period from $6 billion to more than $11 billion. The increase reflected a shift in preference to high-cost, high-tech modalities, especially CT and MR. Utilization among cardiologists exploded.

Vantage Titan, a wide-bore 1.5T scanner, highlights MR offerings from Toshiba America Medical Systems at the RSNA meeting this week. The work-in-progress features a bore 18% wider than any 1.5T scanner currently on the market, according to the company. A specially designed gradient system offers an amplitude of 30 and a slew rate of 130 to expand the field-of-view.

Inspired by vertebroplasty's success, Greek researchers have shown that percutaneous cement injections can also successfully stabilize arthritic and neoplastic lesions affecting the femoral head. The technique offers pain relief and an alternative to surgery in selected patients.

The latest evolution of GE Healthcare's Signa HD x (high definition x) platform offers MR pulse sequences that overcome barriers to diagnostic scans in some difficult-to-image patients. The xt version, shown at the RSNA meeting, features two major innovations: 3D Cube and Ideal.

In a surprising discovery, researchers from Germany have found that whole-body staging of patients with recently diagnosed malignant melanoma using either MRI or PET/CT could miss a substantial number of metastatic lesions.

Confirma is showing at the RSNA meeting its breast MR coil enhanced with interventional components. Launched at RSNA 2006 as a purely diagnostic device, the Access Breast Coil is now outfitted with a grid plate and stabilization plate, a configuration cleared in July by the FDA. The four-channel phased-array coil was also modified to improve patient comfort, reduce weight, and increase physician access to the patient. The version slated for the RSNA exhibit floor is certified for use on Siemens Avanto, Espree, and Symphony MR scanners.

Providers can eliminate the use of gadolinium-based contrast by using new pulse sequences from Toshiba America Medical Systems. The angiography techniques rely on differences in the MR signal that distinguish blood and surrounding soft tissue.

An analysis of imaging data suggests that PET/CT should be the modality of choice for directing cervical cancer patients to appropriate therapy.

Paramed Medical Systems showcased an upgrade to its U-shaped open system MR scanner. The 0.6T midfield system, MR-Open, now features a large field-of-view and a closed cooling system for the superconducting magnet.

Injections of corticosteroids and anesthetics guided by CT or MR imaging offer a reliable therapeutic option for the treatment of chronic lower back pain from sacroiliac joint lesions, according to researchers from Germany and the U.S.

Providers can eliminate the use of gadolinium-based contrast by using new pulse sequences from Toshiba America Medical Systems. The angiography techniques rely on differences in the MR signal that distinguish blood and surrounding soft tissue.