Alcohol consumption that amounts to less than one alcoholic beverage per week during pregnancy can change fetal brain structure and delay brain development, according to a fetal magnetic resonance imaging (MRI) study presented at the 

Radiological Society of North America (RSNA) 2022 Annual Meeting

“Identification of the teratologic toxic effects on human brain development opens new diagnostic opportunities for fetal neuroradiology, allowing early postnatal support programs in these cases and stimulating the discussion of alcohol prevention during pregnancy to promote public health,” wrote Gregor Kasprian, M.D., an associate professor of radiology in the Department of Biomedical Imaging and Image-Guided Therapy at the Medical University of Vienna in Austria, and colleagues.

While alcohol consumption during pregnancy has been shown to affect fetal brain development, early structural alterations of this development have not been systematically studied. In this prospective single center study, the researchers used fetal MRI to assess the effects of alcohol exposure on brain development.

They analyzed MRI exams of 24 fetuses with prenatal alcohol exposure who were at 22 to 36 weeks of gestation at the time of MRI. Alcohol exposure was determined via two anonymous questionnaires: the Pregnancy Risk Assessment Monitoring System (PRAMS), a surveillance project of the Centers for Disease Control and Prevention and health departments, and the four-question T-ACE Screening Tool. The average alcohol consumption was less than one alcoholic drink per week, according to the study.

The MRI exams of 20 fetuses were included in the final analysis and were 1:1 age matched to healthy controls. Brain maturation was assessed by using the fetal total maturation score (fTMS) based on super-resolution-postprocessed T2-weighted/steady state free precession (SSFP) sequences in three planes (1.5T). Temporal and occipital sulci depth and brain asymmetry expression in the temporal lobe were also quantified.

Compared with the controls, fetuses exposed to alcohol had a significantly lower fTMS score and a shallower right superior temporal sulcus (STS), a region involved in social cognition, audiovisual integration, and language perception.

"We found the greatest changes in the temporal brain region and STS," noted Dr. Kasprian. "We know that this region, and specifically the formation of the STS, has a great influence on language development during childhood."

Further, the delayed fetal brain development could be specifically related to a delayed myelination stage and less distinct gyrification in the frontal and occipital lobes.

"Pregnant women should strictly avoid alcohol consumption," said lead author Patric Kienast, M.D., a Ph.D. student in the Department of Biomedical Imaging and Image-Guided Therapy in the Division of Neuroradiology and Musculoskeletal Radiology at the Medical University of Vienna. "As we show in our study, even low levels of alcohol consumption can lead to structural changes in brain development and delayed brain maturation."

To assess how these structural changes will affect brain development, “we need to wait for the children who were examined as fetuses at that time to get a little older, so that we can invite them back for further examinations," said Dr. Kienast. "However, we can strongly assume that the changes we discovered contribute to the cognitive and behavioral difficulties that may occur during childhood."

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Researchers found that even low amounts of alcohol consumption in pregnant women can lead to early and diffuse structural changes in brain regions related to key functions including language development.

What an MRI Study Reveals About Low Alcohol Use During Pregnancy and Fetal Brain Structure

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 

"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

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

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

Fujifilm Healthcare Americas Corporation has launched the Scenaria View Focus Edition computed tomography (CT) system, a device that may enhance cardiac imaging and reportedly reduces radiation dosing by up to 83 percent.

, which received 510(k) clearance from the Food and Drug Administration (FDA) in April 2022, may be utilized for a variety of routine and advanced applications, including dual energy exams, interventional radiology procedures and coronary computed tomography angiography (CCTA), according to the company. The new CT system will be showcased at the upcoming Radiological Society of North America (RSNA) annual meeting November 27 to December 1 in Chicago.

Fujifilm said a unique feature of the Scenaria View Focus Edition CT system is the Cardio StillShot, a cardiac motion correction tool, which captures two data sets in each scan that are subsequently compared to help detect and correct heart motion. The Cardio StillShot allows temporal resolution of 28 milliseconds with final images in comparison to 175 milliseconds with conventional image reconstruction, according to Fujifilm.

In comparison to conventional filtered back projection image reconstruction, Fujifilm said the Scenaria View Focus Edition’s use of iterative reconstruction reduces radiation dosing by up to 83 percent and reduces image noise by up to 90 percent.

“Providers need a powerful CT system that gives them the diagnostic confidence to make the right treatment decisions for their patients,” noted Mark Silverman, the director of marketing for CT at Fujifilm Healthcare Americas Corporation. “Fujifilm’s Scenaria View Focus Edition makes this possible through the convergence of high temporal resolution, enhanced workflow that reduces examination time, and advanced dose reduction capabilities.”

The recently launched Scenaria View Focus Edition computed tomography (CT) system features an advanced cardiac motion correction tool that reportedly provides significantly higher temporal resolution than conventional image reconstruction.

New Computed Tomography System Offers Potential Benefits in Cardiac Imaging

Whether it’s the advent of Smart Noise Cancellation or the enhanced imaging of X-ray systems such as DRX-Compass and DRX-Evolution Plus, Carestream has embraced the technology of artificial intelligence (AI) and what it can do for radiologists.

 sat down with Ron Muscosky, the worldwide product line manager for software solutions for Carestream, to discuss the company’s emerging innovations with AI technology. Watch below:

Videos

Innovations with artificial technology (AI) are fueling product advances that offer enhanced image quality, patient positioning and workflow efficiencies.

How Carestream's AI-Enabled Products are Improving Quality and Efficiency for Radiologists

Offering an array of promising benefits including quality imaging, usability across devices and enhanced portability due to lighter weight and an ergonomic design, Carestream’s Lux 35 Detector appears to check off a number of boxes for busy radiologists.

 sat down with Jill Hamman, the global product marketing manager for X-ray solutions for Carestream, to discuss the advantages of the 

The portability and durability of the device may make it an emerging option for bedside imaging.

A Closer Look at Carestream's Lux 35 Detector

It was good (and exhausting) to be back in person at 

. While virtual meetings are sometimes necessary to protect public health, there is no substitute for face-to-face interaction.

As I reflect on my experience at this year’s meeting, I believe that radiology is as innovative as ever, but there appeared to be a more deliberate focus on getting back to basics and focusing our efforts around the patient. Here are a few key themes:

A common theme among my conversations with colleagues is that radiologists feel swamped – too much work, too few people, and no end in sight. Unfortunately, burnout is not a new issue for radiologists, and 

 for years. The demands of the pandemic have only made things worse.

There is also a weariness about adding another tool to the stack. Radiologists need help, but they aren’t looking for the expense and time commitment it takes to get a new technology up and running. Any new solution would need to demonstrate clear value to the radiologist, without making it too difficult to implement and begin using it.

In previous RSNA events, “interoperability” was the buzzword. This year, I heard “orchestration” all week long.

 on how to solve key challenges radiologists are facing. Traditionally, adding tools to bring in insights from artificial intelligence (AI) or improve workflows just resulted in more work for the radiologist and IT teams. AI in radiology is evolving from its early rapid innovation phase and maturing into more collaborative, integrated approaches to improve the technology’s value to the field.

IBM Watson Health is among the companies taking this approach. 

At RSNA, the company launched two orchestration solutions

 to help imaging organizations improve the radiologists’ experience while reducing demands on IT.

3) Consolidation will be a continuing trend.

Four or five years ago at the RSNA annual meeting, you would find aisle after aisle of small vendors offering clinical decision support solutions. It seemed that any person with a dream had a booth that boasted a new way to help clinicians order the right test at the right time.

I didn’t see many of these solutions this year, and I suspect it is because some of the best innovations have been absorbed into companies or options to deliver solutions at scale.

This is yet another symptom of an evolving perspective on technology in radiology: innovation is vital, but likely won’t achieve success in isolation. Rather, innovation needs to measurably impact workflow in a positive way, and it needs to scale.

4) The future of radiology is bright with innovation.

Radiology has seen exponential progress when it comes to better imaging to help us see the detail we need to assess and treat health conditions. Clinicians and technology are better together than either one would be alone.

When compared with previous RSNA meetings, this year’s event seemed to offer fewer examples of specific technical leaps forward – like faster magnetic resonance (MR) screening or advancements in coils. (One possible exception was the exciting buzz around 

.) Instead, people seemed more focused on the innovations that promise to integrate technology in a more cohesive and helpful way.

For all the inspiring innovation we see at RSNA each year, I applaud the satisfying return to our radiology roots. It’s not just about the latest, cutting-edge technology; It’s about being efficient, effective, and doing what’s best for our patients. Imaging should be centered around people, and that was more apparent than ever at RSNA 2021.

Pertinent perspectives on emerging trends in radiology.

Four Takeaways from RSNA 2021

With the continued rise of patient volume and increasingly complex cases, an emerging computed tomography (CT) platform may provide a viable solution in radiology departments with built-in scalability for detector upgrades, increased efficiency and other technological advancements.

Radiological Society of North America (RSNA) 2021 Annual Meeting

, GE Healthcare unveiled a new modular version of the 

 that enables clinicians to do on-site upgrades of the device’s Gemstone

 Clarity Detector for coverage of 40 mm, 80 mm or 160 mm. The system also offers 0.28 second rotation speed with the ability to increase to an 0.23 second rotation speed via an upgrade to Revolution Apex Elite, according to GE Healthcare.

In addition to technology that provides high-definition, low-noise imaging, the Revolution Apex reportedly enhances speed and precision by automating time-consuming tasks prior to, during and after CT scans.

GE Healthcare says the device offers an auto-positioning system, enabled by a 3D camera and an artificial intelligence (AI) algorithm, that helps ensure optimal patient positioning. Other features of the Revolution Apex include a virtual scan assistant to tailor parameters to patient size and indications, as well as the post-scan ability to simultaneously process multiple reconstruction tasks so clinicians can view the images before the patient leaves the room. GE Healthcare says this is particularly advantageous in cases involving polytrauma workup and asserts that one may rule out acute stroke in less than five minutes.

According to GE Healthcare, other benefits of the Revolution Apex CT platform include:

High-resolution imaging in patients with heavily calcified coronaries, plaque and stents

CT planning for transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR) procedures via a single scan and single injection with low-contrast volume

Reduced need for table movement or sedation with lowest dose possible

New MRI System May Provide Enhanced Imaging and Reduced Scan Times

In addition to advancements in the Revolution Apex CT system, GE Healthcare also introduced 

, a new 3.0T magnetic resonance imaging (MRI) system, citing advances in imaging quality, efficiency and patient comfort.

Leveraging AI to bolster image clarity and increase efficiency, the SIGNA Hero device offers AIR Recon DL, a deep learning image reconstruction technology that enables anatomical adaptability and facilitates a 30 to 50 percent reduction in exam times, according to GE Healthcare.

New extensions of this technology, presented at the RSNA conference, include 3D sequences and PROPELLER for motion robustness that reportedly provide “sharper images with better signals in half the time for nearly 90 percent of the daily clinical scans done, regardless of the anatomy being imaged,” according to GE Healthcare.

In combination with the company’s patented AIR Coils, the SIGNA Hero device allow clinicians freedom in positioning the lightweight and flexible coils to help ensure optimal imaging of patients. GE Healthcare says the SIGNA Hero platform enables simultaneous scans of multiple organs with fewer patient adjustments during whole body imaging. The company adds that the device’s One Stop Prostate imaging with AIR Coils and AIR Recon DL make prostate imaging much more comfortable and efficient for patients, allowing for completion of scans in less than 15 minutes.

GE Healthcare notes that the SIGNA Hero device as well as the AIR Recon DL 3D and PROPELLER technologies are currently pending 501(k) approval from the Food and Drug Administration.

GE Healthcare unveils on-site detection upgrades and other advances with CT system as well as a new MRI device.

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