MRI

Most radiology meetings now devote some sessions to the hot topic of nephrogenic systemic fibrosis. The question about which agents are safest invariably comes up during question and answer sessions.

After absorbing the details contained in 924 pages, analysts are finding reasons for both optimism and caution regarding the proposed 2008 Physician Fee Schedule from the Centers for Medicare and Medicaid Services. Radiologists may immediately focus on its 9.9% rate reduction, but the mammoth document also lays out sweeping reforms covering the hot points of alleged kickback and self-referral abuses.

The Children’s Health and Medicare Protection Act of 2007 may look like straightforward legislation to reauthorize a popular healthcare insurance program for poor children, but major reforms directed at medical imaging and the healthcare system as a whole are embedded in the bill passed by the House of Representatives Aug. 1.

MRI has helped researchers identify structural and functional abnormalities in the brains of people experiencing schizophrenic auditory hallucinations. The defects clustered in areas of the brain responsible for processing voices.

From illustrating the effects of minor head injury to showing the brain activation underlying childhood intelligence, studies that combine psychological tests and functional MRI are a powerful and versatile way to make connections between human behavior and neurophysiology.

Minimally invasive approaches that promise to reduce post-therapy morbidity are currently being investigated, but their efficacy will depend on physicians' knowing the exact location of cancer within the prostate. This is where the quality of images attained with 3T MRI could come in, according to Dr. Peter Choyke, chief of molecular imaging at the National Cancer Institute.

show of hands from the audience at a special ISMRM/ESMRMB symposium on nephrogenic systemic fibrosis said a lot without saying a word about the growing prevalence of this condition among patients who have undergone gadolinium-based contrast-enhanced MR imaging.

Armed with endorectal coil MRI and other advanced imaging techniques, radiologists could one day help transform management of the most common cancer in men, saving many from needless impotence, incontinence, and post-treatment recurrence.

MR-guided biopsies at 3T are showing great promise in prostate cancer because of their speed and high tumor detection rate in patients with rising prostate-specific antigen levels but previous negative biopsies, according to a leading research team from the Netherlands.

The 2007 International Society for Magnetic Resonance in Medicine meeting looked backed at past accomplishments and forward to innovations that will define future MRI practice. The meeting, jointly sponsored with the European Society for Magnetic Resonance in Medicine and Biology, was held in Berlin May 19 to 25, two months after the death of Paul Lauterbur, Ph.D., a key figure in the invention of MRI.

Radiologist interest in whole-body diffusion-weighted MRI for cancer applications is intensifying following preliminary studies that demonstrate its potential value for staging cancer. Whole-body DWI produces a composite image using a STIR echo-planar diffusion-weighted technique with a high b-value for background suppression.

Noninvasive cardiac imaging is gaining widespread acceptance. Both CT and MRI can determine the absence or presence of coronary artery disease accurately and reliably. This is done by either assessing the coronary artery morphology or by offering detailed insight into functional aspects and myocardial perfusion.

Profound improvements in perfusion and diffusion tensor imaging over the past few decades are changing the ways in which radiologists understand disease processes, especially those involving small blood vessels in the brain.

Breast carcinomas are the leading cause of cancer death for women worldwide. World Health Organization figures show that more than 1.2 million women are diagnosed with breast cancer each year. About 385,000 of these cases occur in Asia.

Not all those who suffer heart attacks have typical symptoms. Many people, including the elderly, those with renal disease, and women, are at risk of having a silent myocardial infarction. People with diabetes, in particular, are among those at highest risk of experiencing a silent MI. Now there is a clinical MRI technique that can identify abnormal myocardium, which signifies a high-risk profile, in diabetic patients.

righam and Women's Hospital researchers have shown that MR-guided focused ultrasound surgery reduces the painful symptoms of uterine leiomyomas for at least a year after treatment. Better technique and growing experience with the minimally invasive procedure have improved its effectiveness and safety while helping physicians with patient selection.

New research suggests ultrasound won’t cut it as a substitute adjunct study for screening women at high risk for breast cancer.

Breast MRI suffered from a serious image problem during the second half of the 1990s. Because of its limited specificity and high cost, the technique was written off by many specialists, but clinical acceptance of it has increased over the past few years. It is now widely recognized as a valuable adjunct to mammography and ultrasound.

A bioluminescent tumor probe promises to give surgeons a glistening intraoperative view of the dividing line between cancerous and normal tissue.

Legislation proposing accreditation for most medical imaging modalities has been caught up in a fight between Capitol Hill and the White House over the renewal of federal healthcare insurance subsidies for poor children.

The most highly anticipated stroke imaging trial of the year has left radiologists scratching their heads about the disappointing results. No more than 47% of acute stroke patients administered the clot-dissolving protein desmoteplase three to nine hours after the onset of symptoms showed improvement. The positive outcome rate was about the same among patients given a placebo.

A study of more than 4800 hospital patients has established that claustrophobia remains an impediment for MRI practice and a difficult experience for about 2% of patients undergoing MR procedures.

A Duke University study has found that diffusion-tensor MRI paints a more complete picture of ischemic hyperintense lesions in the brain than does conventional MR. Findings suggest that brain abnormalities have a much greater neurological impact for older patients than was previously thought.

Radiologists could be shortchanged if Medicare goes through with plans announced Monday to end its long-standing policy of paying separately for imaging contrast media, radiopharmaceuticals, interventional radiology supervision, and interpretation.

A study comparing six MR and PET brain imaging strategies has found cell proliferation and microcirculation to be best suited for marking the hot spot to optimally grade malignant gliomas.

The European Pharmacovigilance Working Party has recommended that Magnevist (from Bayer Schering) be contraindicated in patients with severe or end-stage renal impairment to help prevent a life-threatening skin disease linked to gadolinium-enhanced MRI, according to industry and U.K. regulatory sources.

Advances in PET and MR have led Alzheimer’s disease experts to propose new criteria for diagnosing the condition, at least when conducting research studies.

Myriad Genetics is the only place to go for BRCA1/BRCA2 mutation testing. The Salt Lake City biopharmaceutical company has a monopoly on the test. Its scientists discovered the BRCA1 and BRCA2 genes in 1996 and patented their use for assessing the risk of genetically related cancer.

Like other medical journalists, I can usually be found in the front rows of the radiology meeting lecture halls, dutifully taking copious notes. The American Roentgen Ray Society meeting in May was no exception. But this time I was also under a vow of silence for three weeks, after a vocal cord nodule diagnosis.

Back pain and weakness of both legs had bothered this 60-year-old woman for one week. Left breast cancer, stage 2, had been diagnosed two years before, and she subsequently underwent a lumpectomy followed by chemotherapy and radiation therapy.