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When it comes to brain imaging, functional MRI – commonly called fMRI – is considered the gold standard. However, it can be costly, time consuming, and come with several restrictions that can prohibit use with certain patients. 

In recent years, investigators have been searching for a different brain imaging method that can side-step these problems and potentially provide better quality scans at the same time. Researchers from the University of Southern California Keck School of Medicine and California Institute of Technology recently succeeded. They’ve developed functional photoacoustic computed tomography (fPACT) – a technique that works by emitting a laser beam of light into the area being imaged. 

Drs. Charles Liu and Jonathan Russin join me to discuss the differences and benefits with fPACT.

Drs. Charles Liu and Jonathan Russin discuss the benefits and potential of fPACT, the alternative to functional MRI.

The Reading Room: Potential fMRI Alternative -- fPACT

Facilitating optimal use of contrast, the Medrad Centargo CT Injection System reportedly combines user-friendly features with workflow efficiency for high-volume CT departments.

FDA Clears Multi-Patient CT Injection System from Bayer

The Ezra Blueprint scan reportedly includes quantitative brain measurements, coronary calcium scoring (CAC) and a full-body MRI that provides screening for over 500 conditions.

Ezra Launches 3T MRI/CT Combination for Full-Body Scans

Adjunctive use of deep learning reportedly led to a 37 percent reduction of interpretation time for cerebral aneurysm assessment on computed tomography angiography (CTA) and greater than a 90 percent reduction in post-processing time. 

Study: AI Model Significantly Enhances CTA Workflow Efficiency and Detection for Cerebral Aneurysm 

Researchers found that ultra-high resolution photon-counting significantly enhanced visualization of small vessels and facilitated improved reduction of blooming artifacts for head and neck computed tomography angiography (CTA) scans.

New Study Assesses Benefits of High-Resolution Photon-Counting for Computed Tomography Angiography 

For patients who had neuroradiological trauma CT scans, researchers noted no significant visual differences between deep learning denoising at 25% mAs and iterative reconstruction at 100% mAs.

Study: Deep Learning Denoising May Facilitate Up to a 75 Percent Reduction in Radiation Dosing for Head CT

The recent Radiology Partners (RP) publication 

Neuroradiology and Stroke Clinical Pathway 

offers a practical best practice guidance for radiologists and technologists on the use and reporting of neuroimaging, including head and neck computed tomography angiography (CTA), cerebral perfusion CT and brain magnetic resonance imaging (MRI), for stroke patients.

In a recent interview, Vivek Bansal, M.D., makes it clear that the publication is geared toward achieving a consistent baseline standard for providing a high level of stroke imaging and care regardless of the size or resources of the given facility.

“We’re not rewriting the guidelines but (trying to) take some of these other hospitals or smaller practices, (facilities) with limited resources, or maybe don’t have neuroradiology specialty coverage, and bring everybody up to some baseline level to where we can say we’re giving optimal stroke care no matter where you go at any RP facility,” noted Dr. Bansal, a Houston-based neuroradiologist who serves as the national subspeciality lead for neuroradiology for Radiology Partners.

Emphasizing the constantly evolving nature and urgency of stroke care, Dr. Bansal said radiologists need to be active members of the stroke care team.

“In particular with stroke, we can’t be radiologists locked in our little reading rooms separate from everybody else and just putting out reports,” maintained Dr. Bansal. “We have to be part of the team … We have pushed to get really granular data and really help find the trouble points and fix them. That’s the key. When you do that, you get a lot of trust from your hospital system, and you can actually make processes better, and do better for the patients.”

(Editor’s note: To download the Neuroradiology and Stroke Clinical Pathway guidance, 

For more insights from Dr. Bansal, watch the video below.

In a recent video interview, Vivek Bansal, M.D., discussed a recent Radiology Partners publication that offers practical tips and best practice guidance on CT and MRI neuroimaging for stroke patients.

Practical Insights on CT and MRI Neuroimaging and Reporting for Stroke Patients

The purchase of new and cutting-edge imaging equipment comes with a lot of excitement—and a learning curve. That's where Canon Medical Education comes in, providing a host of education solutions for clients that include both in-person and virtual training and continuing education opportunities.

The education arm of Canon Medical Systems USA provides a customizable plan to ensure that all imaging associates are well-trained and comfortable operating advanced equipment including MR and CT, as well as vascular and cath applications, among others. 

Understanding that every learner is different, Canon offers educational opportunities that include in-person, at their Institute of Advanced Imaging in Irvine, California; on-site training at a client facility; online and instructor-led courses in their Canon Learning Center; as well as CE and non-CE webinars and special programs.

To learn more about Canon's educational offerings, 

Canon Medical Systems offer a range of in-person and virtual educational opportunities for their clients. 

Education in Radiology: Canon's Customized Approach

Morris Panner didn’t want to call the familiar PACS system outdated or antiquated. However, he did suggest that radiology is on the cusp of a revolution with medical image and data management that parallels the ongoing emergence of the radiologist from the reading room to being a key member of the interdisciplinary team in facilitating optimal patient outcomes.

“The PACS system is no longer a new invention. It is important and you can always improve it but what people are really looking for now is how to free that data, take that pixel information, share it, use it with other types of data and advance the liquidity and flexibility in data management. That was the revolution that came out of the SIIM (Society for Imaging Informatics in Medicine) meeting this year,” noted Panner, the president of Intelerad Medical Systems, in a recent video interview.

recent survey research showing an increasing patient acceptance of artificial intelligence (AI)

, and the more gradual “try it” phase for many radiologists as they discern the most optimal fit for AI in their current workflows. To that end, Panner also reviewed key aspects of Intelerad’s Enterprise Imaging and Informatics Suite. It is Panner’s hope that by emphasizing improved efficiency and quality in radiology workflows, the system can “free up brain space for great diagnostics.”

For more insights from Morris Panner, watch the video below.

In a video interview, Morris Panner, the president of Intelerad Medical Systems, discussed key observations from the recent Society for Imaging Informatics in Medicine (SIIM) conference, recent research about artificial intelligence (AI) adoption and emerging goals for enhancing the efficiency of radiology workflows.

What's Next in Medical Image and Data Management in Radiology?

Is exposure to iodinated contrast media (ICM) a potential issue for young pediatric patients? The Food and Drug Administration (FDA) recently advised clinicians to ensure thyroid monitoring for patients three years of age and younger within three weeks after exposure to ICM. However, a 

recently published statement from the American College of Radiology (ACR)

 has raised questions about the FDA guidance.

In a recent video interview, Jonathan R. Dillman, M.D., MSc, who co-authored the ACR statement, noted 

several issues with the 11 studies the FDA used to support the guidance

In addition to a lack of prospective data and a lack of control groups in most of the studies cited by the FDA, the majority of the studies focused on high-risk pediatric patients such as low birth weight premature babies, neonates and those with congenital heart disease, according to Dr. Dillman, the associate chief of research in the Department of Radiology and the medical director of the Imaging Research Center within the Division of Radiology at the Cincinnati Children’s Hospital Medical Center.

Dr. Dillman said the FDA guidance is too broad and not supported by the current research.

“Wherever the science takes us, that is where we want to go. The science at this time we do not believe calls for universal thyroid monitoring after intravascular CT (computed tomography) in children three months of age and up. … There is really no evidence to support that,” maintained Dr. Dillman, who has served on the ACR’s Drugs and Contrast Committee since 2007.

For more insights from Dr. Dillman, watch the video below:

In a video interview, Jonathan Dillman, MD, MSc discussed a recently published statement from the American College of Radiology (ACR) that questioned the literature support for a March guidance from the Food and Drug Administration (FDA) about thyroid monitoring for children three years of age or younger within three weeks of exposure to iodinated contrast media (ICM).

Iodinated Contrast Media Exposure: Is Subsequent Thyroid Monitoring Warranted for Young Pediatric Patients?

In a new study presented recently at the 8th European Academy of Neurology (EAN) Congress in Vienna, Austria, researchers from Denmark found that patients who tested positive for COVID-19 were 3.5 times more likely to be diagnosed with Alzheimer’s disease and 2.6 times more likely to have Parkinson’s disease in comparison to patients without COVID-19. 

(Editor's note: For a related article, see "New Study Shows Link Between COVID-19 and Elevated Risks for Neurological Disorders.")

In a recent video interview, neurologist Pardis Zarifkar, MD discussed the findings of the exploratory observational study.

The study authors also found that patients with COVID-19 had a 2.7 times higher risk of ischemic stroke and a 4.8 times higher risk for intracerebral hemorrhage. While the higher prevalence of cerebrovascular disorders was expected given the previously reported association between these disorders and COVID-19, the “extent of the increase (with neurodegenerative disorders) was quite surprising,” noted Dr. Zarifkar, who is affiliated with the Department of Neurology at Rigshospitalet in Copenhagen, Denmark.

That said, Dr. Zarifkar emphasized that “neurodegenerative disorders are a long time in the making” and it is “highly unlikely” that a COVID-19 infection could cause the development of a neurodegenerative disorder at one year.

While maintaining that more research is needed to evaluate potential long-term neurological complications with COVID-19, Dr. Zarifkar is also hopeful that future studies will examine the phenomenon of cognitive and mental health issues after critical illness.

For more insights from Dr. Zarifkar, watch the video below:

In a recent video interview, neurologist Pardis Zarifkar, MD discussed a new study that found significantly elevated risks for Alzheimer’s disease and Parkinson’s disease among patients who tested positive for COVID-19. 

Video Interview: Is There an Increased Incidence of Neurodegenerative Diseases in Patients with COVID-19?

The temporary shortage of iodinated contrast media (ICM) has been a huge issue in the radiology community, not to mention the overarching impact on the health-care field. While there is proverbial light at the end of the tunnel with the 

recent announcement from GE Healthcare about resuming full production of Omnipaque products

, Sean Bryant, M.D. said there are key takeaways that radiologists can utilize in the next couple of weeks as contrast supply begins to be restored and moving forward.

In a recent video interview, Dr. Bryant, the owner and president of Diversified Radiology, discussed the impact of the ICM shortage in the neuroradiology space. In addition to appropriate use of alternative imaging, such as substituting magnetic resonance imaging (MRI) or non-contrast computed tomography (CT) for contrast-enhanced CT scans, Dr. Bryant said the guidelines from the American College of Radiology (ACR) and the American Society of Health-System Pharmacists (ASHP) have been helpful in managing the ICM shortage.

Dr. Bryant said the ICM shortage also was an opportunity to reassess imaging protocols and educate patients as well as referring clinicians on alternatives to high contrast imaging. In emergency departments, oncology care and in-patient services in a hospital, Dr. Bryant noted that clinicians at times opt for high contrast without knowing the most optimal study to order for a given clinical scenario.

For additional insights from Dr. Bryant, watch the video below.

In a recent video interview on the current iodinated contrast media shortage, neuroradiologist Sean Bryant, MD discussed imaging alternatives, emphasized communication with referring physicians on optimal studies, and discussed the ongoing need to prevent “protocol creep” with timely updates of imaging protocols.

Lessons Learned from the Iodinated Contrast Media Shortage: A Neuroradiologist's Perspective

Perhaps the biggest challenge in radiology right now is the current global shortage of iodinated contrast media (ICM), which is most commonly utilized for computed tomography (CT) exams. With the temporary shortage expected to last until the end of June, radiology departments and larger medical facilities are scrambling to address this issue, which can have a significant impact on patient care.

With this in mind, we recently spoke with two professors from the Yale School of Medicine: Dr. Joseph Cavallo, an Assistant Professor of Radiology and Biomedical Imaging, and Dr. Jay Pahade, an Associate Professor and Vice-Chair of Quality and Safety for Radiology and Biomedical Imaging.

co-authored an article on strategies that imaging facilities may take to address this acute shortage of iodinated contrast media.

 They outline three central strategies including ICM dose reduction, utilization of alternative imaging modalities and possible deferment of imaging deemed to be non-urgent in nature.

Dr. Pahade called ICM a mission critical agent.

“Most institutions rely heavily on contrast-enhanced CT for the management of their patients both inside and outside of the emergency department (ED). Almost every critical diagnosis in medicine has some arm tied to CT imaging in one fashion or another,” emphasized Dr. Pahade.

For additional insights on the shortage of iodinated contrast media, watch the video below.

In a recent video interview, two radiology professors from the Yale School of Medicine discussed the impact of the iodinated contrast media (ICM) shortage and potential strategies, ranging from ICM dose reduction to possible deferment of non-urgent imaging, that may provide a viable path moving forward. 

Emerging Strategies for Managing the Acute Shortage of Iodinated Contrast Media

Despite the technological advances in transferring electronic health information, medical imaging data, to this day, is predominantly exchanged between instiutions via physical media (such as a CD or flash drive) that patients carry to an appointment at another facility.

Emphasizing the impact of this seemingly dated practice on workflow efficiencies within radiology and the broader field of health care, Arun Krishnaraj, MD, MPH and David Larson, MD, MBA, said the continued reliance on patients to transport medical images via physical media (such as a CD or flash drive) can lead to delays in patient care.

In their quest to change this dynamic, Drs. Krishnaraj and Larson recently co-authored a provocative article, “

Moving Toward Seamless Interinstitutional Electronic Image Transfer

ournal of the American College of Radiology (JACR)

. In the article and in a video interview with 

, Drs. Krishnaraj and Larson discussed the potential creation of a “linked multi-hub model” that would facilitate electronic transmission of medical images through image exchange companies that would connect different health-care facilities.

“Everyone in the imaging community should really see this as a call to arms to work with our imaging vendor exchange communities to solve this problem for the benefit of patients,” emphasized Dr. Krishnaraj, Chief of the Division of Body Imaging with the Department of Radiology and Medical Imaging at the University of Virginia School of Medicine.

For more insights from Drs. Krishnaraj and Larson, watch the video below:

In a recent video interview, Arun Krishnaraj, MD, MPH and David Larson, MD, MBA, discussed the continued use of physical media to transport medical images between different health-care facilities, resulting inefficiencies and delays with patient care, and the initiative to create a linked multi-hub model to end this dated practice once and for all.

'A Call to Arms' for Electronic Transfer of Medical Images Between Institutions

While magnetic resonance (MR) perfusion is not exactly new, Kevin J. Abrams, MD, says the potential of dynamic susceptibility contrast with MR perfusion is exciting as it “allows you to hopefully differentiate active spine disease versus treated spine disease in a patient who has metastatic cancer.”

This was just one of the takeaways Dr. Abrams had after attending the 25th Annual Symposium of the American Society of Spine Radiology (ASSR). In a recent video interview with 

, Dr. Abrams also praised discussions of imaging for spontaneous intracranial hypotension (SIH). In addition to learning more about the risk of superficial siderosis in patients with this condition, he noted strong lectures on the use of CT myelography and digital subtraction myelography to diagnose different types of cerebrospinal fluid (CSF) leaks associated with SIH.

Dr. Abrams said another highlight talk was a lecture on the use of dual-energy CT to differentiate between acute and chronic vertebral fractures. He added that he started to incorporate this modality more in his practice shortly after attending the ASSR conference. The combination of artificial intelligence and augmented reality, as discussed at the ASSR meeting, has the potential to supplant procedure videos in the training of radiologists as it “feels like you’re doing the procedure before you do the procedure,” noted Dr. Abrams, the chief of radiology at Baptist Hospital of Miami, and a clinical associate professor of radiology at the Herbert Wertheim School of Medicine at Florida International University.

For additional insights from Dr. Abrams about the ASSR conference, watch the video below:

In a recent video interview, Kevin J. Abrams, MD, discussed highlights from the recent 25th Annual Symposium of the American Society of Spine Radiology (ASSR), including lectures on imaging for spontaneous intracranial hypotension, the emergence of dynamic susceptibility contrast for MR perfusion and insights on the use of dual-energy computed tomography (CT) for diagnosing vertebral fractures.

Key Highlights From the Annual Symposium of the American Society of Spine Radiology

As the country--and the world--continues to grapple with the ongoing COVID pandemic, the imaging industry is looking to re-find its footing in an evolving landscape where customized solutions are key to success. 

Enter Canon Medical's Cartesion Prime digital PET/CT, introduced in 2019, which provides a high-performance, adaptable system for today's evolving imaging technology. Optimizing both workflow and image quality via advanced silicon photomultiplier design with 

one-to-one coupling, fast time-of-flight and deep learning reconstruction technology, 

his advanced technology has led to image quality improvements, while optimizing dose efficiency to reduce patient risk and speeding up acquisition time for improved throughput," said Tim Nicholson, managing director, Molecular Imaging Business Unit, Canon Medical Systems USA. 

, Nicholson expanded on the needs of the industry and how Canon is answering the call. 

Canon's latest entry into the PET/CT market is a digital, air-cooled system that provides customizable solutions for a range of clients. 

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