Ultrasound

Breast ultrasound significantly increases detection of cancers in high-risk women but takes a big toll on the rate of benign biopsies, according to the initial results of a screening trial sponsored by the American College of Radiology Imaging Network and the Avon Foundation.

For nearly a decade, radiologists have used breast ultrasound as an adjunct to x-ray mammography to avoid unnecessary biopsies in equivocal cancer cases. Now ultrasound innovations that increase image resolution while decreasing operator dependence are reflected in a study published in the July issue of Radiology.

Three-D ultrasound designed for cardiac imaging may be just what interventionalists need to improve the administration of nerve blocks, according to researchers at the Mayo Clinic in Jacksonville, Florida.

The number of image-guided percutaneous interventions being performed, including tissue biopsies, fluid aspiration, and catheter insertions, has increased markedly. The rising popularity of these procedures is due to their less invasive nature and lower risk compared with surgery, their high diagnostic accuracy, and the substantial cost savings they provide.

Brigham and Women's Hospital researchers in Boston 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.

Doppler ultrasound breast tumor exams conducted prior to chemotherapy can reliably predict the outcome of treatment, according to research conducted in India. Most breast cancer is treated with chemotherapy prior to surgery. The traditional way to assess the success of this chemotherapy is to study tissue samples collected at surgery. In this study, researchers developed a scoring method using Doppler ultrasound to predict chemotherapy success.

Both ultrasound alone and ultrasound-guided fine-needle aspiration biopsy of lymph nodes are reliable ways to stage invasive lobular carcinoma, a form of breast cancer occurring in only 10% to 15% of cases. Although preoperative assessment can be quite challenging with this cancer, research from the University of Texas M.D. Anderson Cancer Center in Houston found ultrasound to be as effective for staging invasive lobular carcinoma as it is for the more common invasive ductal carcinoma.

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The American College of Radiology has asked members for feedback on a draft of clinical performance measures involving several radiology subspecialty areas. The measures, designed to improve the quality of medical services, may be used to support pay-for-performance plans sponsored by the Centers for Medicare and Medicaid Services.

Doing full fetal anatomical surveys during follow-up exams of low-risk pregnancies can identify unanticipated fetal anomalies, particularly if the exams are intended to monitor fetal growth.

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Radiology practitioner assistants can perform image-guided venous access procedures just as safely as do interventional radiologists, IR fellows, and residents, according to a study in the August issue of the Journal of Vascular and Interventional Radiology.

Ultrasound could stand in for MRI in evaluating muscle atrophy in diabetic patients, with the advantage of being a bedside tool, according to Danish researchers.

Three-D ultrasound designed for cardiac imaging may be just what interventionalists need to improve the administration of nerve blocks, according to researchers at the Mayo Clinic in Jacksonville, FL.

Researchers at the Dana-Farber Cancer Institute in Boston have developed a PET/CT database of clinical data that are not usually available through conventional PACS and HIS/RIS.

The birthplace of hand-carried ultrasound is now grooming another innovative development, this one using ultrasound in therapy rather than diagnosis.

Sonographic measurements of kidney length can provide valuable information about kidney function in transplant patients and donors, according to a study by Italian researchers. Kidney length correlated with glomerular filtration rate, the gold standard for measuring kidney function.

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This month’s review includes a study that compared several sonography-based techniques to determine which one is the best suited for the detection and characterization of breast tumors. We also found an interesting paper comparing 3D sonography and MRI for the quantitative assessment of lung volumes in fetuses with congenital diaphragmatic hernias. In a different study, Chinese researchers used contrast-enhanced ultrasound to pick the best candidates for radiofrequency ablation of hepatocellular carcinomas. We also found a study by U.S. researchers who evaluated Doppler sonography’s usefulness to diagnose hepatic artery thrombosis in adult patients who have undergone liver transplantation. And we suggest browsing a study by Spanish investigators who propose 3D sonography as a reproducible test for the classification of adnexal masses.

To those who sit at an ultrasound console, the probe they twist and slide into position is the means to an end. For most, it is a clinical end. But, increasingly, ultrasound is being mobilized not to diagnose but to entertain and even to persuade.

Ultrasound-guided radiofrequency is generally a safe treatment for liver masses and carries an acceptable level of risk, but patients with large tumors and baseline liver function impairment have a higher risk of complications, according to researchers in Taiwan.

The Society of Radiographers in the U.K. has published a guidance to help prevent work-related musculoskeletal disorders, the most common work-related illness in Britain.

Researchers in Japan have found contrast-enhanced ultrasound with advanced dynamic flow is a highly sensitive way of showing intestinal ischemia in patients with bowel obstruction and very useful for diagnosing the condition. They found diminished and absent color signals during ultrasound exams indicated the presence of intestinal ischemia.

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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.

Second-generation contrast agents reveal the healing process, as injured muscle tissue in professional athletes grows new blood vessels and repairs muscle damage. Ultrasound scans performed at regular intervals after injury allowed researchers to monitor the repair process and estimate when the athletes could safely return to full activity, potentially reducing relapses and complications.

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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.

Big-ticket items are suffering this year as reimbursement cuts resulting from the Deficit Reduction Act have had a wider and longer lasting effect than initially expected. Particularly hard hit has been PET/CT. The hybrid juggernaut had defied the odds for several years, marching forward with ever higher sales despite utilization rates at individual sites that allowed plenty of unused capacity.

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.