The Food and Drug Administration (FDA) has granted 510(k) clearance for the BodyTom® 64 Point-of-Care Mobile Computed Tomography Scanner, according to NeuroLogica, the manufacturer of the device and subsidiary of Samsung Electronics.

Incorporating clinician feedback in regard to the BodyTom Elite CT system, NeuroLogica doubled the capability of the 

to generate upward of 64 cross-sectional images of a patient’s body and added a Linux operating system.

The device can reportedly be utilized in a variety of settings. For interventional radiologists, NeuroLogica said the BodyTom 64 provides multi-slice CT capabilities and facilitates easy rescans for stages of needle guidance. The BodyTom 64 device can provide neuroimaging guidance for extracranial procedures and is well-suited to trauma and emergency room settings with a unique combination of battery operation and internal lead shielding, added NeuroLogica.

“We’re thrilled to build off our expertise and elevate point-of-care imaging with our BodyTom64, which can transform any room in a hospital into an advanced imaging suite,” noted Jason Koshnitsky, senior director of Global Sales and Marketing at NeuroLogica.

Articles

Enhancements for the BodyTom 64 Point-of-Care Mobile Computed Tomography (CT) Scanner include upgraded cross-sectional imaging capabilities and a Linux operating system.

NeuroLogica Gets FDA Nod for New Mobile CT Scanner

Emphasizing a variety of artificial intelligence (AI) algorithms and workflows across multiple imaging modalities and disciplines on one platform, Philips launched a new edition of the Advanced Visualization Workspace at the Radiological Society of North America (RSNA) annual conference in Chicago.

With the goals of streamlined radiology workflows and improved diagnostic confidence, the 

 provides a suite of enhanced imaging options with more than 70 clinical applications for radiology, oncology, neurology, and cardiology, according to the company.

Philips said the new applications include:

• CT ASPECT (Alberta Stroke Program Early CT Score), an AI-powered tool that enables the scoring of early brain infarction on non-contrast CT exams for patients who have had an ischemic stroke.

• MR cardiac suite that provides diagnostic support and facilitates reporting with one overview of all imaging data types.

• CT Liver Analysis, which allows analysis and quantification of liver segments and other defined regions of interest.

“At this year’s RSNA, Philips will showcase how our informatics solutions use intelligence to provide patient-centric insights, integrate advanced visualization tools into the workflow and support clinical collaboration to speed up detection of diseases by leveraging intelligence everywhere along the patient care journey,” noted Reema Poddar, the president of Diagnostic and Pathway Informatics at Philips.

Offering more than 70 clinical applications, the next-generation edition of the Advanced Visualization Workspace reportedly includes enhanced liver analysis and artificial intelligence (AI)-powered scoring of early brain infarction noted on computed tomography (CT) scans for patients with ischemic stroke.

Philips Launches AI-Enabled 'Visualization Workspace' at RSNA

Using ultra-high field 7T magnetic resonance imaging (MRI), researchers have identified enlarged perivascular spaces (EPVS) in the brains of individuals with migraine, according to emerging study findings presented at the 

Radiological Society of North America (RSNA) 2022 Annual Meeting

"To our knowledge, this is the first study using ultra-high-resolution MRI to study microvascular changes in the brain due to migraine, particularly in perivascular spaces," said co-author Wilson Xu, an M.D. candidate at the Keck School of Medicine of the University of Southern California in Los Angeles. "Because 7T MRI is able to create images of the brain with much higher resolution and better quality than other MRI types, it can be used to demonstrate much smaller changes that happen in brain tissue after a migraine."

While migraine may be associated with vascular-related changes in the brain, such as white matter hyperintensities and cerebral microbleeds, the association with EPVS has not been thoroughly investigated.

"Perivascular spaces are part of a fluid clearance system in the brain," explained Xu. "Studying how they contribute to migraine could help us better understand the complexities of how migraines occur."

In the study, the researchers used ultra-high field 7T MRI to compare structural microvascular changes in 10 individuals with chronic migraine, 10 individuals with episodic migraine without aura and five age-matched headache-free healthy controls. Participants were aged 25 to 60 years. Exclusion criteria included overt cognitive impairment, brain tumor, prior intracranial surgery, MRI contraindications and claustrophobia.

Neuroimaging data were collected via 7T MRI scans using T1, T2, FLAIR and susceptibility-weighted imaging (SWI)/quantitative susceptibility mapping (QSM) sequences. The researchers calculated EPVS in the centrum semiovale and basal ganglia. White matter hyperintensities were measured using the Fazekas scale and cerebral microbleeds were rated using the microbleed anatomical rating scale. The researchers also recorded the duration and severity of disease, presence of aura, side of headache and symptoms at time of scan.

When compared with the healthy controls, the number of EPVS in the centrum semiovale, but not the basal ganglia, was significantly higher in participants with migraine. The frequency of white matter hyperintensities and cerebral microbleeds in participants with migraine did not differ significantly from that of healthy controls. However, EPVS quantity in the centrum semiovale significantly correlated with deep white matter hyperintensity severity in participants with migraine.

"Although we didn't find any significant changes in the severity of white matter lesions in patients with and without migraine, these white matter lesions were significantly linked to the presence of enlarged perivascular spaces. This suggests that changes in perivascular spaces could lead to future development of more white matter lesions," said Xu.

The authors concluded that significant differences in the EPVS in participants with migraine compared with healthy controls “might be suggestive of glymphatic disruption within the brain, but whether such changes affect migraine development or result from migraine is unknown.” They suggested that further study with larger populations and longitudinal follow-up is needed to better establish the relationship between structural changes and migraine development and type.

"The results of our study could help inspire future, larger-scale studies to continue investigating how changes in the brain's microscopic vessels and blood supply contribute to different migraine types," said Xu. "Eventually, this could help us develop new, personalized ways to diagnose and treat migraine."

New magnetic resonance imaging (MRI) research suggests a significant link between deep white matter hyperintensity severity and increased quantity of enlarged perivascular spaces in the centrum semiovale among people with migraines. 

Ultra-High-Resolution MRI Identifies Enlarged Perivascular Spaces in People with Migraines

Acute aortic dissection is reportedly misdiagnosed in 57 to 85 percent of cases with a mortality rate approaching 50 percent within 48 hours of onset.

 However, emerging research, presented at the recent VEITHSymposium, suggests the use of artificial intelligence (AI) algorithm may enhance the detection of aortic dissection on computed tomography (CT) angiography.

In a retrospective review of 1,303 chest and thoraco-abdominal CT angiography scans

, researchers compared the Viz Aortic Dissection Algorithm (Viz.ai), a deep learning, AI-based software application, to ground truth consensus of three board-certified radiologists. According to the study, the data set was comprised of 137 CT angiography exams positive for aortic dissection and 1,166 dissection-negative exams.

The study authors found that the Viz Aortic Dissection Algorithm had a 94.2 percent sensitivity rate and a 97.3 percent specificity rate. The algorithm also had a positive predictive value of 80.1 percent and a negative predictive value of 99.3 percent, according to the research.

The researchers suggested the algorithm could enhance patient triage with earlier diagnosis and accelerated care coordination possibly leading to more timely interventions and improved outcomes.

“The application of this aortic algorithm into the workflow has the potential to move the needle for care teams treating this deadly disease,” noted study co-author Peter D. Chang, M.D., co-director of the Center for Artificial Intelligence in Diagnostic Medicine at the University of California-Irvine (UC-Irvine).

1. Levy D, Goyal A, Grigorova Y, Farci F, Le JK. Aortic Dissection. 

https://www.ncbi.nlm.nih.gov/books/NBK441963/

 . Updated May 2, 2022. Accessed November 21, 2022.

2. Viz.ai. Viz.ai announces positive new data from large aortic dissection AI real-world study at the 2022 VEITHSymposium. 

https://www.businesswire.com/news/home/20221118005105/en/Viz.ai%E2%84%A2-Announces-Positive-New-Data-From-Large-Aortic-Dissection-AI-Real-World-Study-at-the-2022-VEITHsymposium%E2%84%A2

 . Published November 18, 2022. Accessed November 23, 2022.

New research suggests the Viz Aortic Dissection Algorithm has a 94.2 percent sensitivity rate for detecting aortic dissection on computed tomography (CT) angiography.

AI-Powered Algorithm May Enhance CT Assessment of Aortic Dissection

A recent report from the American Lung Association indicated that only 5.8 percent of Americans eligible for lung cancer screening follow through with the preventative, life-saving measure.

However, detection of early-stage lung cancer via low-dose computed tomography (CT) may lead to a 20-year survival rate of 80 percent, according to the findings of a large international study being presented next week at the Radiological Society of North America (RSNA) annual conference in Chicago.

In the study of 1,285 people with early-stage lung cancer diagnosed on CT scans, researchers noted a 100 percent 20-year survival rate for 139 study participants with non-solid lung nodules, and 155 patients with partly solid nodules. The study authors also pointed to a 73 percent 20-year survival rate in 991 people who had solid nodule presentations.

“What we present here is the 20-year follow-up on participants in our screening program that were diagnosed with lung cancer and subsequently treated,” noted lead study author Claudia Henschke, Ph.D., M.D., a professor of radiology and director of the Early Lung and Cardiac Action Program at the Icahn School of Medicine at Mount Sinai in New York. “The key finding is that even after this long-time interval, they are not dying of their lung cancer.”

Henschke and colleagues also noted an 86 percent survival rate for people diagnosed with stage 1A lung cancers and a 92 percent survival rate for study participants who underwent resection of pathologic stage 1A tumors that were 10 cm or less in average diameter and width.

“While screening doesn’t prevent cancers from occurring, it is an important tool in identifying lung cancers in their early stage when they can be surgically removed,” said Dr. Henschke.

All of the study participants were enrolled in the International Early Lung Cancer Action Program (I-ELCAP), a multinational program that emphasizes advance CT lung cancer screening and has enrolled over 87,000 people since 1992.

1. American Lung Association. New report: Critically low lung cancer screening rates reveal opportunity to save more lives. Available at: 

https://www.lung.org/media/press-releases/state-of-lung-cancer-2022

 . Published November 15, 2022. Accessed November 21, 2022.

2. Radiological Society of North America (RSNA). Lung cancer screening dramatically increases long-term survival rate. Cision. PR Newswire. Available at: www.prnewswire.com/news-releases/lung-cancer-screening-dramatically-increases-long-term-survival-rate-301681836.html . Published November 22, 2022. Accessed November 22, 2022.

Emphasizing the benefits of annual lung cancer screening with low-dose computed tomography (CT), researchers noted high 20-year survival rates for a variety of early-stage lung cancer tumor presentations, including a 100 percent survival rate for those with non-solid or partly solid cancerous nodules.

New Computed Tomography Study Shows High 20-Year Survival Rates for Early-Stage Lung Cancer

Eric Postal, MD, is a diagnostic radiologist with the University of Pittsburgh Medical Center. 

Once you notice certain things, they suddenly seem to be everywhere. Theses things are often annoying. One thing that I noticed a few years back was the tendency of tabloids (and subsequently my Internet news feeds) to have headlines hyping numerical lists. Chances are that you have seea few of these headlines. 12 ways to lose weight before the holidays! 7 habits of highly successful people! 13 actors you've completely forgotten about but are still out there!

Partially, it got under my skin because I wanted to know how the industry had glommed onto this gimmick, and why they knew it would be successful. Did they just stumble across it, or had psychological types somewhere figured out that it was a semi-magical formula for attracting readers?

I still don't know, but clearly it works because it is still going strong. Near as I can tell, there aren't certain numbers that work better than others. This is kind of funny since many of these lists include pure fluff, or things that anybody would know without reading the pieces. Why include three wasteful items in your list of nine when a headline boasting six would have done just as well?

Whatever the case, I figured I might as well make use of the trick for one of my blogs. My radiological career hasn't exactly been traditional, so perhaps my perspective from off the beaten path will be of interest to those who remained on it.

 I could have sworn I wrote a blog about this at some point, but a search of my records indicates otherwise. Your motivations and metrics for professional success, career satisfaction, etc. should be the ones that guide you. Whether you are an academician or private practitioner, onsite or telerad, diagnostician or interventionalist., feel no shame or pressure if someone who chose a different path takes a poke at yours. (Don't go poking at colleague career choices. It's not a good look.)

 Unless you happen to hit the lottery or find other reason to retire early, you're in this career for the long haul. Multiply whatever conditions you're thinking of enduring (or enjoying) by a pragmatic factor of forever. Perfect situations are vanishingly rare, and holding out for one isn't a great strategy. try to think about which seemingly minor "I can put up with this for now" imperfections today will evolve into "I can't take this anymore" in a few months or even years.

 You probably can't remember the first few times you read any particular type of study in residency, but chances are you recognize how much more efficiently, quickly, and accurately you do it now. Part of what happened was that you developed good habits. These may include a search pattern when looking at the actual images, hanging protocols and dication macros that work best for you, etc. When a good habit is ingrained, it takes less energy and effort but habits can be unlearned too. Be on guard against slacking off. For instance, some may consider skipping review of sagittal and coronal recons if the axials looked totally normal. However, not doing it once or twice can lead to doing it rarely if at all. Also, it doesn't matter how old and wise you get. New good habits can always be learned.

4) That goes for non-radiological stuff too.

 You could have the best set of professional skills out there, but that radiological brick house isn't going to remain all that impressive if it's missing a decent foundation. Short yourself on sleep, eat bad (or too much) food, or fail to get regular exercise, and it will impact the rest of your performance. Such things are perfect examples of habits trumping conscious effort. If getting to bed on time is part of your routine, you'll do it far more automatically and reliably than if it's a nightly toss-up whether you notice the clock while you're rewatching your favorite movie for the gazillionth time.

 One tends to compete with others of similar capability. It doesn't matter if you're a rad, an engineer, or a professional athlete. Aside from the extreme outliers (at both the superstar and scrub ends of the spectrum), there's usually very little individual difference in performance. If everybody in your practice reads with 99 percent accuracy, for instance, how likely is it you'll be celebrated for doing 99.1 percent? So don't let that be the only feather in your cap. Choose easier ways. Show up on time, answer emails or return phone-calls promptly, and generally make dealing with you a pleasure. You might be amazed how many colleagues get left in your dust.

 An awful lot of people can't. They cling to what is known, whether from a considered appraisal of the devil they know, or simpler things like ignorance of what else is out there and laziness against pursuing it. The more one has to lose, it seems, the stronger the inclination to "stand pat." A lot of opportunities can be missed this way and, not uncommonly, the status quo gradually deteriorates even as folks cling to it. Don't needlessly imprison yourself. Throw out the excuses and be willing to consider the potential of new opportunities.

 It can be tricky to find time for anything extra given the hours some rads can pull, especially when you count in ancillary obligations like CME. The "lifestyle" things I mentioned above (adequate sleep, exercise, even a social life) also take chunks out of the day. But try to find opportunities to "feed your head” as the song says. In addition to the value of simply broadening your mind, you never know when some of the stuff you pick up might synergize with your professional life. Building a "talent stack," as podcaster/author/artist Scott Adams writes, can come back to benefit you in all sorts of ways.

Building a career for the long haul requires a foundation of good life and work habits as well as an openness to innovation and change.

Seven Personal Truths from Charting My Own Radiological Course

New research, based on susceptibility-weighted magnetic resonance imaging (MRI) of the brain, reveals significant differences in the brain stem and frontal lobe up to six months after people had COVID-19.

For the study, researchers obtained susceptibility-weighted MRI scans from 46 people within six months of recovery from COVID-19 and compared them to 30 healthy controls. The researchers identified high susceptibility values with significant clusters in the frontal lobe and brain stem for those who had COVID-19.

The frontal lobe clusters included portions of the right and left orbito-inferior frontal gyrus and adjacent areas of white matter, according to the researchers, 

who will be presenting their findings next week at the Radiological Society of North America (RSNA) annual conference in Chicago

“These brain regions are linked with fatigue, insomnia, anxiety, depression, headaches and cognitive problems,” noted study co-author Sapna S. Mishra, Ph.D(c), who is affiliated with the Indian Institute of Technology in Delhi.

Mishra said the “significant abnormalities in COVID survivors” also included a cluster in the right ventral diencephalon region of the brain stem. The researchers noted this region is associated with a variety of functions including sensory and motor signal processing, hormone release, and regulation of circadian rhythms.

In order to determine potential long-term implications of these brain changes, the researchers are currently in the midst of conducting a longitudinal study of the same patient cohort.

“(The current) study points to serious long-term complications that may be caused by the coronavirus, even months after recovery from the infection,” noted Mishra. “The present findings are from the small temporal window. However, the longitudinal time points across a couple of years will elucidate if there exists any permanent change.”

COVID-19 may cause changes in the brain stem and frontal lobe that could lead to fatigue, impacts in motor signal processing, insomnia, and depression, according to emerging research to be presented next week at the Radiological Society of North America (RSNA) annual conference in Chicago.

Brain MRI Study Shows 'Significant Abnormalities' Up to Six Months After COVID-19

's Weekly Scan is your chance to catch up on the latest radiology content, from new research and device news to the latest case quizzes and conference reports. Review the slideshow below to see this week's top content:

Diagnostic Imaging's Weekly Scan: November 13-November 19

Slideshows

Catch up on the top radiology content of the past week.

Noting that the last research to examine racial differences in breast cancer imaging characteristics was published nearly 25 years ago, researchers recently compared imaging findings between African American women and non-Latina White women in a new study of over 800 women with invasive breast cancer or ductal carcinoma in situ (DCIS).

For the retrospective study, recently published in 

, the authors examined data from 270 African-American women and 586 non-Latina women. According to the study, there were 278 cancers in the African-American cohort, including 166 screen-detected cancers and 112 clinical cancers. In the non-Latina White women cohort, there were 599 cancers, including 397 screen-detected cancers and 202 clinical cancers.

In comparison to non-Latina White women, the researchers found that African-American women in the screen-directed cohort had a lower rate of architectural distortion (6.1 percent) on mammography than non-Latina White women (15.9 percent), and a higher rate of calcification (38.8 percent vs. 28 percent). 

However, the researchers pointed out that the higher calcification rates were primarily seen in women with DCIS as calcification rates were comparable between African-American women and non-Latina White women who had invasive breast cancer (9.5 percent vs. 8.5 percent). African-American women with screen-detected breast cancer not only had a higher rate of DCIS in comparison to non-Latina White women (42.2 percent vs. 29 percent), they also had a significantly higher rate of pure DCIS, a finding that had not been reported in previous research, according to the study authors.

“The higher rate of DCIS in our study may reflect racial differences in screening mammography utilization as this was not demonstrated in the clinical cohort,” wrote Steven P. Poplack, M.D., who is affiliated with the Department of Radiology at the Stanford University School of Medicine, and colleagues.

In women who had invasive breast cancer, the study authors noted a higher frequency of masses among African-American women in comparison to non-Latina White women (77.9 percent vs. 64.9 percent). Overall, African-American women had higher rates of oval or round masses on mammography (43.1 percent vs. 21.4 percent) and ultrasound screening (24.1 percent vs. 13.1 percent) in comparison to non-Latina White women, according to the study.

While mass margin differences were not apparent in the clinical cohort, Poplack and colleagues said ultrasound imaging revealed a higher percentage of circumscribed mass margins in African-American women (17.5 percent) in contrast to non-Latina White women (2.7 percent). Mammography imaging showed a higher rate of spiculated margins in non-Latina White women (65.1 percent) in comparison to African-American women (39.7 percent), according to the study.

“Familiarity with these imaging appearances and consideration of underlying socioeconomic differences may provide breast imagers with a better framework to approach breast cancer diagnosis in the (African-American) population in their clinical practice,” noted Dr. Poplack and colleagues.

In regard to study limitations, the authors noted that it wasn’t clear in the data whether digital mammography or digital breast tomosynthesis (DBT) was utilized in screening. They acknowledged the study findings were subject to incomplete or inaccurate reporting as the extracted data was derived from exam reports without image review. Programmatic cost constraints prevented consistent use of DBT screening in navigator-based programs for lower-income patients, most of whom were African American women, according to the study authors.

In a study of over 800 women with breast cancer, researchers found that African-American women had a higher rate of ductal carcinoma in situ (DCIS) and were less likely to have irregular masses in screening exams in comparison to non-Latina White women.

Study Examines Racial Differences in Mammography and Ultrasound Imaging Characteristics of Breast Cancer

Is it time to reassess first-line imaging for the detection of hepatocellular carcinoma (HCC) in high-risk patients?

, researchers compared contrast-enhanced ultrasound (CEUS) with perfluorobutane and modified 2017 Liver Reporting and Data System (LI-RADS) criteria versus contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) with 2018 LI-RADS criteria. The study population consisted of 171 patients deemed to be high-risk for HCC.

The use of CEUS with perfluorobutane had equivalent sensitivity (92.1 percent), specificity (87.1 percent) and accuracy rates (90.6 percent) in detecting HCC lesions as CT and MRI (89.5 percent, 84.2 percent, and 87.7 percent, respectively), according to the study. The study authors also noted LI-RADS category concordance between the two diagnostic approaches on 139 of 171 cases, including 99 LR-5 assessments.

“Given the favorable performance compared with the current preferred tests of contrast-enhanced CT and contrast-enhanced MRI, the findings support the application of modified CEUS criteria using perfluorobutane for characterizing focal liver lesions as HCC in high-risk patients,” explained Jianhua Zhou, M.D., Ph.D, who is affiliated with the Department of Ultrasound at the Sun Yat-Sen University Cancer Center in Guangzhou, China, and colleagues.

While acknowledging a low detection rate for washout in the past that contributed to CECU’s significantly lower sensitivity rate for detecting HCC in comparison to MRI and CT, the study authors suggested the use of perfluorobutane for assessment of a Kupffer defect has enhanced the sensitivity of CEUS for HCC. Zhou and colleagues found that 98.2 percent of HCCs had a Kupffer phase defect on CEUS in comparison to 95.6 percent of HCCs revealing a non-peripheral washout on MRI or CT, and 86.8 percent of HCCs showing a portal-venous or late phase washout pattern on CECU.

“The findings indicate the potential impact of selecting perfluorobutane as the contrast agent for CEUS to allow lesion characterization in the Kupffer phase,” added Zhou and colleagues.

In regard to study limitations, the authors acknowledged the inherent limitations with a small sample size and retrospective design. They noted the possibility of selection bias due to potential confounding factors with the study. Zhou and colleagues also pointed out the study was performed in an area with a high prevalence of chronic hepatitis B, which may prevent extrapolation of the findings for patients at high risk for HCC due to risk factors such as cirrhosis and hepatitis C.

Emerging research showed the combination of contrast-enhanced ultrasound (CEUS) with perfluorobutane and modified 2017 LI-RADS criteria had comparable sensitivity, specificity, and accuracy to current magnetic resonance imaging (MRI) and computed tomography (CT) approaches to detecting hepatocellular carcinoma (HCC) lesions.