MRI

Most orthopedic implants are made from nonferromagnetic materials and, therefore, tend to be acceptable for patients undergoing MRI examinations. In vitro testing conducted at 1.5T and 3T has verified the safe aspects of orthopedic devices with regard to magnetic field interactions (see www.MRIsafety.com for a summary of this information).

Most U.S. breast specialists are performing contrast-enhanced breast MRI, albeit at a fairly low volume, according to a survey presented today at the American Roentgen Ray Society meeting in Orlando. About one-third of facilities performing breast MRI do not offer MRI-guided biopsies as well, however.

Three-D MR imaging has led to new insights concerning the relationship between dysfunctional gray matter and the physiological effects of lithium therapy for bipolar disorders. The findings were reported in April in an online version of the journal Biological Psychiatry.

Practitioners can choose either vertebroplasty or kyphoplasty to treat vertebral compression fractures until a prospective trial comparing the two techniques says otherwise, according a multisociety position statement in the Journal of Vascular and Interventional Radiology. The statement does not fully address the economic impact of each treatment choice.

Lower costs, speedier recovery, and reduced pain give uterine artery embolization an edge over surgery for fibroid treatment, according to a multicenter trial that examined the relative merits of the two methods.

Correct diagnosis of tumor character and stage is fundamental to lung cancer therapy planning, but evaluating indeterminate solitary pulmonary nodules continues to challenge radiologists. It is vital to determine as soon as possible, however, whether patients are likely to respond to treatment.

Dementia affects between 1% and 6% of people over the age of 65 and 10% to 20% of those over 80. As more and more individuals survive into old age, the absolute number of dementia sufferers is likely to soar.

MRI has great value in guiding treatment of breast cancer patients and is well worth the extra expense when used appropriately. Accurate assessment of the extent of disease prior to breast surgery is essential if inappropriate procedures and repeat conservation surgeries are to be avoided, according to speakers at ECR 2007.

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.

MRI can be daunting enough for claustrophobic patients. But now arachnophobia may be a good reason to fear entering the tube. Researchers have begun studying large eight-legged creatures with clinical MR systems (Magn Reson Imaging 2007;25:129-135).

Diagnosing pancreatic disease generally requires many different imaging procedures. Ultrasound and CT are most commonly used to evaluate the pancreatic ducts, parenchyma, and adjacent soft tissues. CT-based assessment of pancreatic pathology has been greatly aided by the advent of multislice technology.

MRI will continue to evolve and will remain the dominant imaging technology in medicine, according to a leading world expert on the modality.

In late November, nearly 300 doctors and imaging center managers paid $325 each for a day-long seminar sponsored by the law firm McDermott Will & Emery. They packed a large ballroom in the swank Ritz-Carlton Hotel at Water Tower Place in Chicago to learn how to turn referrals to imaging facilities into lucrative income streams.

Peripheral MR angiography (far right) is improved on first-pass imaging due to the high relaxivity of the MR blood pool agent Vasovist. The extended imaging window provided by the agent supports steady-state imaging not possible with other MR contrast media, producing ultrahigh spatial resolution MRA (second pass) demonstrating both arteries and veins in detail.

Whole-body MR imaging could complement-and, in some cases, even replace-traditional bone scanning techniques. Researchers across Europe have found that whole-body MRI has a significant impact on patient management compared with x-ray and nuclear medicine.

Striking the right balance between quality and throughput is never easy, especially when the queue of referrals seems never to end. Shorter scan times mean that another patient or two could be squeezed onto the day's work list.

Europeans are advised to follow steps outlined in the U.S. to prevent a life-threatening skin condition linked with gadolinium-enhanced MRI or MR angiography, according to a new editorial in European Radiology. The article stresses the importance of caution in high-risk patients for all gadolinium agents, not just the ones that have been associated with reactions, because the condition’s causes are still unclear.

Technical advances in MRI have paved the way for functional imaging of the abdomen, moving beyond simple morphological evaluation of disease and in some cases proving superior to multislice CT.

Multislice CT has steamed into our radiology departments like a nuclear-powered aircraft carrier. In its wake, an entire support industry has sprung up to help us quench our ever-increasing thirst for more and better slices.

MRI has proven to be a reliable, fast, noninvasive means for assessing deep fat in adults. It can also be effective in high-risk pre-adolescents and adolescents, according to a study in the March issue of Radiology.

So what do you use your 3T system for?Five years ago, that question would have been a good opening for a detailed discussion onthe strengths and weaknesses of high-field MRI.

Advances in coil technology and the development of tailored sequences have made 3T a versatile alternative to 1.5T. But it will be a long time until it displaces 1.5T as the workhorse of MR.

Recently published studies reflect the versatility of cardiac MR, multislice CT, rubidium-82 PET/CT, and stress echocardiography for shedding diagnostic light on various aspects of coronary artery disease and other cardiac conditions.

The American College of Radiology has added cardiac MRI to its growing menu of facility accreditation programs.

The current fiasco over the European Union Directive on electromagnetic fields illustrates exactly why the newly formed European Society of Radiology (ESR) is so urgently needed.

Over the last several years, imagers and patients have witnessed passionate debate, sometimes even legal action, involving breast MR imaging. Dissent has finally given way to consensus over a few key points: Breast MRI is meant to complement, not replace, mammography or sonography, and it's a handy tool to guide biopsies, assess disease before surgery, and evaluate treatment response.

Heart failure is a common disorder with high morbidity and mortality. It is the only major cardiovascular disease whose prevalence and incidence are not only on the increase but predicted to reach epidemic proportions.

European legislation aimed at protecting workers from harmful effects of electromagnetic radiation, such as that emitted by mobile phones and electrical power lines, could unwittingly change the course of MR imaging if efforts to amend the law fail, according to Prof. Gabriel Krestin, who spoke in March at a press conference at the European Congress of Radiology.

A multicenter prospective trial involving 1210 patients in Europe has found that the odds of a favorable clinical outcome were one-third higher for acute stroke patients who received diffusion/perfusion MRI to determine the appropriateness of tPA thrombolysis than for patients assessed with conventional noncontrast CT.

The feasibility of 3T MR as a general-purpose clinical imaging modality is an ongoing controversy. Although whole-body 3T MRI has been available for several years, most systems to date have been sold to university hospitals and research facilities.