Jennifer-Leigh Oprihory

Siemens’ MAMMOMAT Inspiration Prime Edition mammography system aims to decrease radiation dose by up to 30 percent by replacing the use of a scatter radiation grid - which, by virtue of radiation absorption, increases patient dose - with a progressive image reconstruction algorithm. The system is pending 510(k) clearance.

Siemens touted the ACUSON Freestyle ultrasound system as the first wireless transducer ultrasound system, which aims to streamline the ultrasound process. It also increases the level of sterilization within the ultrasound laboratory, since the wireless transducer is designed to be fully immersible in liquid for disinfection purposes, the company said.

Philips' MicroDose Mammography Single-Shot Spectral Imaging (SI) uses X-ray photon-counting technology that reduces dosage by up to 50 percent, achieves 50 micrometer resolution and boasts a collimator design that rejects 97 percent of scatter with 100-percent pixel warranty, according to the company. It also allows for Spectral Breast Density Measurement. This product is not commercially available in the U.S.

Philips highlighted its iMR, or Iterative Model Reconstruction, which seeks to achieve low-contrast CT images that are nearly free of noise. The technology is pictured here as part of Philips' Ingenuity Flex32 CT Scanner during RSNA 2012.

Shimadzu’s MobileDaRt Evolution features three-second image verification, an output of up to 32 kW, keyless verification, wireless networking, bedside drive controls and improved mobility.
 

GE's Silent Scan technology (demonstrated here via a live broadcast of a scan) uses a new 3-D acquisition and reconstruction technique called Silenz to eliminate acoustic noise generated by MR scans. The system is pending 501(k) approval.

GE's Universal Viewer allows users to work on oncology and mammography imaging within a single workspace that features a user interface that can adapt to radiologist preferences, embedded clinical applications, and remote image access for referring physicians. This application was one of several major workflow solutions being highlighted at RSNA this year.

Toshiba's Aquilion RXL allows for lose-dose CT scanning with a high-resolution detector, accelerated workflow and automated processing, including ultrafast data transfer, clinical application software packages and automated bone-removal algorithms, according to the company.

Merge's closed loop imaging solution aims to improve the patient experience through features such as consumer option information (to give them increased control over provider choices), mobile payments and HIPAA-friendly cloud access to their medical images. It also allows health care providers to view business-end analytics (such as referral rates, scheduling date preferences and profit/loss information), access patient images via cloud technology and share data with other clinicians who use the Merge system.

Hitachi's SCENARIA CT system looks to promote patient comfort with a 750 mm aperture and to increase patient safety by reducing dosage through the use of a 0.35-second rotation speed, lateral table movement, a bow-tie filter, automatic exposure control and interactive processing, according to the company.

The Carestream DRX-Revolution Mobile X-ray System features an automatic collapsible column, storage bins, badge-swipe log-in, a wireless DRX digital detector, an in-cart detector battery charger, 2 touch-screen displays, prior-image review, a tube-and-grid alignment system, easy maneuverability and a maximum power output of 32 kW.


M*Modal's Speech Understanding technology uses a combination of speech recognition and natural language understanding to comprehend meaning and syntax and process speech into structured and encoded documents. It also boasts a cloud-based platform, continuous learning, information-driven workflows and unstructured data analytics, according to the company.

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CHICAGO - From dose-reduction and workflow solutions to MR and mammo innovations, the RSNA 2012 exhibit floor was buzzing with new products. Here’s a sampling.

RSNA 2012 Slideshow: On the Exhibit Floor


CHICAGO - When it comes to MR scans of the men and women who scale mountains, there may be more than meets the eye.

New research shows that high-altitude cerebral edema (HACE), the end stage of severe acute mountain sickness - once thought to be reversible - causes microbleeding on the brain.
Michael Knauth, MD, PhD, presented the findings from a study aimed at detecting brain bleeds in survivors of HACE, comparing their MR results with survivors of other altitude-related illnesses.

His team theorized that hemosiderin deposits on the brain left by HACE-related hemorrhaging should cause enough of a magnetic disturbance to show up on an MR, but that differences in MR sensitivity might have been throwing readings off in T2-weighted imaging. For this reason, the team decided to use an alternative method, susceptibility-weighted imaging (or SWI), to look for HACE-related microbleeds that MR might have missed.

Knauth explained that Peter H. Hackett, MD’s work with MRIs of Mt. McKinley-area climbers in the 1990s set the stage for the investigation of HACE-related brain changes.

“He investigated climbers that were flown down or carried down from the mountain McKinley with HACE,” he said. “What he found was high-signal changes in the part of the brain we call the corpus callosum.”

Since the climbers with whom Hackett was able to follow up showed no signs of HACE afterwards, Hackett concluded that HACE was characterized by a reversible edema that liked to attack that part of the brain.

But, in the course of their own research, Knauth’s team encountered an outlier.

Namely, they came upon the case of a 50-year-old female patient who experienced HACE upon visiting the Andes Mountains. When her brain was scanned after the fact using SWI, microbleeds showed up as black dots on her brain. Hers marked the first case in which a living person was documented as having HACE-related microhemorrhages.

This led them to launch the current study based on a three-part hypothesis, all based on the assumption that the woman could not be the only HACE patient of her kind.

To counter this imbalanced detection during their study, the researchers used susceptibility-weighted imaging, the same kind of test used on the female HACE survivor. Following the success of a pilot study of six mountaineers, the team launched a study of 36 mountaineers: 10 HACE survivors, 11 severe AMS survivors, eight HAPE survivors and seven high-altitude mountaineers who lacked HACE, AMS and/or HAPE despite having made multiple expeditions sans supplemental oxygen.

“We performed a blood-sensitive sequence in all these subjects,” Knauth said. “Neuroradiologists were blinded to the mountaineers’ status.”

He and his research associates then scored the SWI readings as being positive for HACE, negative for HACE or questionable. Eight of out 10 HACE survivors, 10 out of 11 AMS survivors, seven out of eight HAPE survivors and five out of seven high-altitude survivors were correctly scored. Knauth pointed out that while the incorrect scores may have been legitimately wrong , the mountain-climbing attitude might have made study participants negligence to disclose all cases of HACE.

Researchers concluded that HACE is not fully reversible.

“There are changes to be seen years after a survived HACE,” Knauth said. “Microbeeds are found almost consistently and almost exclusively in the brains of HACE survivors, but not in the brains of other mountaineers who experience trouble at high altitudes.”

Knauth said that while the neuropsychological consequences of the microbleeds are still unclear, there is not data suggesting that they cause impairment.

Figure 1. The images show magnetic resonance (MR) slices through the brains of two mountaineers. The image on the left is from a mountaineer who climbed to altitudes above 7,000 meters, and the one on the right is from a mountaineer who survived a high altitude cerebral edema (HACE). 

The arrows point to a brain structure which is called corpus callosum-it consists of densely packed nerve fibres connecting the two brain hemispheres. This part of the corpus callosum is normal in the left image, whereas in the right image (HACE survivor) it shows black spots representing multiple small hemorrhages (microhemorrhages). Courtesy RNSA.

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CHICAGO - High-altitude cerebral edema, the end stage of severe acute mountain sickness - once thought to be reversible - causes microbleeding on the brain.

MRI Shows Mountain Climbers Face Higher Risk of Brain Bleeds

CHICAGO - According to a new study, radiologists are pretty mysterious creatures.

But, according to Peter Miller, MD, they don’t have to be.

"The times of the invisible radiologist need a transition to the times of patient-centered radiology, with radiologists playing an active role in patient care and being more visible to their patients,” Miller said, who co-presented 

 with his colleague, Richard Gunderman, MD, PhD, at RSNA 2012 this week.

“We sought to understand what patients know about radiologists,…to understand what patients want from their radiologists,…what patients want to know about their radiologists, and we wanted to answer the question, ‘Is it important to patients to know who is reading their radiology study?’” Miller explained, going on to identify the desire to improve radiologists’ value as physicians and the improvement of patient-centered care as additional study goals.

Researchers surveyed 307 hospital patients (with a 50/50 split between education levels of high-school or lower versus some college or higher). Of these respondents, 8.8 percent admitted to having no clue what radiologists do; 55.4 percent felt confused, and only 35.8 percent said they knew.

Only 53.5 percent believed radiologists are physicians, according to the study, and 32.7 percent believed radiologists to be technologists, instead.

The survey included questions about radiologist importance and patient transparency (i.e. doctor choice and medical-data access). In response, 52.8 percent said the identity of their image-reader was very important, 61.9 percent expressed an interest in getting copies of their radiology reports and 62.7 percent expressed interest in reviewing radiologists’ biographies and pictures online.

This study builds on another published in 2008 by the American College of Radiology, wherein one in two Americans didn’t know what a radiologist was.

Miller and Gunderman, professor and vice chair of radiology at the Indiana University School of Medicine, shared on-the-job anecdotes about the confusion.

But neither let flashes of humor distract from the issue of increasing the public’s understanding of radiology.

According to them, the best ways to fight the lack of information and improve patient-centered care is be to increase patient education about radiology, to make necessary changes to the system in terms of institutional-practice and department shifts and to pay more attention to patient knowledge disparities and needs. Miller then stressed the need to shift radiologists’ focus from gaining referring physician loyalty to patient loyalty.

“It turns out it’s much more fulfilling to be a doctor when you interact with patients face to face, when you feel that ‘I’m not just analyzing images, I’m actually caring for this human being,’” Gunderman said.

“Your day at the office, or your day at the hospital, or your career in a field like radiology ends up meaning a lot more to you when you feel that you’ve made that kind of difference in the care of your patients.”

CHICAGO - Many patients are confused about what radiologists do, but they want to know their image reader. It’s time to up the education and interaction.

Author | Jennifer-Leigh Oprihory

Articles

RSNA 2012 Slideshow: On the Exhibit Floor

MRI Shows Mountain Climbers Face Higher Risk of Brain Bleeds

Many Patients Aren’t Sure What Radiologists Do