Diagnostic Imaging Vol 30 No 11

Siemens Healthcare wants to move PET/CT into the radiology department. The German multimodality vendor, a pioneer in PET and an innovator in CT technology, plans to accomplish this with a hybrid scanner that integrates off-the-shelf components from these two modalities into a spectrum of possibilities united by design and marketing elements oriented toward radiologists.

CT vendors have diverged this year as never before, choosing technological paths to new generations of scanners that reflect their own particular engineering strengths and history of R&D. Core developments by each have translated into novel capabilities. Software and mechanical fixes have countered weaknesses.

MR vendors have been chipping away at new clinical applications for years. They have pointed to 3T as the means to expand routine practice in ways that are not routine, adding computing engines to handle the massive volumes of data that would gush forth, expanding data pipelines, building out coils with extended channels-in short, creating the infrastructure to support a new diagnostic order. This year, they mean business.

Two and a half years worth of data suggest that CT is the most accurate, cost-effective imaging modality for diagnosing the causes of large bowel obstruction, according to investigators in the U.K.

Whether we would like to admit it or not, medical imaging is slowly on its way to becoming a commodity, which has been defined by Wikipedia as "anything for which there is a demand, but which is supplied without qualitative differentiation across a given market."

Molecular imaging is rapidly advancing as a biomedical modality that increases the understanding of underlying cellular mechanics and dynamics and adds a new dimension to the diagnosis and treatment of disease. It may be a sensitive and specific method for evaluating cancer by measuring the expression of genes that trigger oncogenesis and stratifying tumors on the basis of their biological characteristics.

Imaging research from the University Medical Center Utrecht, the Netherlands, suggests that measuring with MRI the intracranial pressure of infants with progressive hydrocephalus helps physicians to determine the right time for surgical intervention.

Evaluation of carotid artery plaquedensity performed on serial ultrasoundscans could help identifypatients at high risk for a heart attackor other adverse cardiovascular events,according to Austrian researchers.

High-field MR imaging is rapidly gaining clinicalacceptance as a preferred platform. Its impact onimaging of the musculoskeletal system has beendramatic, spurred in part by the increasing availabilityof 3T systems in clinical and academic settings andby ongoing research demonstrating numerousadvantages

Missed lung cancer is a source of great concernamong radiologists and an important medicolegalchallenge. Failing to diagnose lungcancer ranks second only to overlooking breast canceras a cause of litigation among radiologists in theU.S. Lung cancer may be missed on either chestradiography or CT.

Since full-field mammographystarted going digital eight yearsago, systems based on flat-panelarrays have dominated. But computedradiography has begun seeping intothat market and, if the FDA allowsCR companies to apply for streamlined510(k) approval of mammographyupgrades, the trickle of CR productscould turn into a flood.

During tens of thousands of patient consultations every day, physicians make bad decisions about ordering diagnostic imaging. They may prescribe brain MRI because it is faster to write an order than to conduct a routine neurological exam. They may call for an abdominal CT without realizing that diagnostic ultrasound is cheaper and equally effective.

While radiology is the highest paid and most popular specialty, primary care remains the lowest paid and least popular among graduates, according to a research letter published in the Journal of the American Medical Association.

Merging multiple CT images increases the accuracy of probe repositioning during radiofrequency ablation treatments of various lesions, according to a recent study performed at Dartmouth-Hitchcock Medical Center.

A recent study at the Oregon Health and Science University in Portland has confirmed that 3T MR imaging improves on 1.5T MRI for detecting and characterizing struc-tural brain abnormalities in patients with focal epilepsy.

I would like to end this month's Utilization Review Committee meetingby once again addressing the radiology department's failure to rein in inappropriate studies and reports without proper clinical history.

Stanford University has joined other high-profile medical schools and research institutions in severely restricting funding from pharmaceutical and device companies for continuing medical education programs-including programs for radiologists and radiology technologists.

Dynamic contrast-enhanced MRI may be an alternative to invasive exploratory surgery for assessing lymph node status and determining if breast cancer patients require radiation treatment.

An interactive web cartoon titled "Welcome to the Radiology Center" teaches sick children what to expect before undergoing an MR, CT, or chest x-ray study. It also gives them a sense of mastery and adventure while enhancing compliance with the procedures.