CT

A decision by GE Healthcare to introduce a new line of compact CT scanners, the BrightSpeed, reflects a major trend in the market toward miniaturization. The new scanners will be unveiled at the RSNA meeting.

There was a time when all that really mattered in medical imaging was technology that dealt with, well, medicine. That’s changed. Though clinical molecular imaging using advanced biomarkers is still a ways away, we’ve opened the door a crack to use miniature PET scanners in animal research with these agents. Now one of life’s inevitabilities is wedging the door open a bit more.

Siemens hopes to redefine CT with the introduction of a scanner that combines two 64-slice imaging chains in a single unit.

Many CT sites around the world still run single-slice scanners, according to GE Healthcare. GE is doing something about it.

Nuclear medicine scientists expressed dismay about Congressional approval of a federal budget plan that could close the book on a half-century of nuclear medicine research sponsored by the Department of Energy.

Dynamic Imaging prepares enhanced RIS/PACSVisitors to the Dynamic Imaging exhibit booth at the RSNA meeting will see the company’s version of its IntegradWeb RIS/PACS. The system builds on the Web-based architecture of its predecessors to address ambulatory settings. Included in the IT package are RIS, PACS, billing, document management, and digital dictation.

The radiology industry appears to have bounced back from a bruising first half-year, during which the number of radiological devices cleared lagged far behind the pace set in the last two years. Thirty-three such devices passed FDA muster in September, just shy of the year’s highwater mark of 35 set in August.

The Centers for Medicare and Medicaid Services has decided to apply the federal physician self-referral law to nuclear medicine, reduce technical payments for cross-sectional imaging of contiguous body parts, and reduce payments on the Physician Fee Schedule, according to the final rule published by CMS this month.

Researchers have generally discarded the notion of virtual colonoscopy screening in children because colonic pathology in pediatric patients is rare and radiation exposure is a concern. A study from Argentina, however, has found that pediatric patients with suspected polypoid lesions of the colon can safely undergo diagnostic low-dose CT colonography. The low-dose protocol could have implications for adult colon cancer screening as well.

Diagnostic imaging's crucial role in medical practice is affirmed by the eagerness with which referring physicians have embraced diagnostic ultrasound, MR, CT, and nuclear medicine for an ever-lengthening list of clinical roles. Evidence now suggests that referring physicians appreciate diagnostic imaging so much, for both clinical and financial reasons, that a growing number are intent on making it their own. They are using exemptions in federal antireferral law that allow them to add high-tech imaging to their menu of in-office services.

"Few radiologists understand preventive cardiology. They are enamored with less noisy pictures, and that's it. And few traditionally trained cardiologists care about coronary prevention and risk stratification of the asymptomatic person. Prevention falls to the primary-care doctor who, sadly, witnesses the specialists' apathy.

Doves like truces. A truce gives the two sides a chance to enjoy peace, if only for a short time. Maybe they’ll like it enough to stop fighting altogether, or so the thinking goes.

Software from GE Healthcare and Siemens Medical Solutions is extending CT perfusion techniques beyond stroke assessment. Primary applications are in oncology, but much more may be possible.

GE enhances ProdigyBone densitometry isn’t just for adults any more. GE Healthcare has enhanced its Prodigy bone mineral density system to support pediatric applications. New tools evaluate the pediatric skeleton relative to a child’s body size and skeletal age, as well as chronological age comparison. The upgrade was unveiled at the American Society for Bone and Mineral Research meeting in Nashville Sept. 23 to 27.

The surge in FDA clearances that typically occurs in the months preceding the RSNA meeting may have gotten off to an early start. Manufacturers earned clearances for 35 devices from the FDA in August, the highest total of the year and at least a 50% jump over the months from March through July.

The ability to acquire functional and anatomic information in a single scheduled exam offers many clinical and workflow benefits. But making the most of a hybrid imaging system involves far more than simply pressing the "on" switch. With the advent of multislice SPECT/CT, radiologists and nuclear medicine physicians are taking a long, hard look at how these systems will fit into clinical practice.

Nuclear medicine physicians would be the first to admit that the resolution of their color maps could be better. Despite the ability of radioisotope tracers to home in on likely areas of malignancy, poor spatial resolution can hinder precise localization of pathology.

Imaging of infection provides a classic example of nuclear medicine's strengths and weaknesses. Radiopharmaceutical tracers can locate infection sites with great accuracy. As with oncology imaging, however, the absence of anatomic landmarks makes it difficult to determine the location to which the hot spot on a color map corresponds. A better road map, capable of locating the position of signal more precisely, would make it easier to diagnose the cause of infection and plan the most appropriate treatment.

Combined SPECT/CT scanners are receiving a warm welcome in the nuclear cardiology community. Acquisition of CT data immediately before or after a myocardial perfusion SPECT exam is proving to be an effective means of minimizing attenuation artifacts. Multislice SPECT/CT units could also pave the way to comprehensive assessments of cardiac function.

The marriage between PET and CT worked so well it made CT almost a standard component of any PET purchase. As installations of SPECT/CT begin, observers are waiting to see how this latest hybrid compares.

Few radiologists would disagree that computer-assisted detection in the colon has a long way to go before it is ready for routine clinical implementation. But once the remaining technical challenges have been overcome, advocates for CT colonography screening will have a far stronger case, according to speakers at the CARS meeting in June.

Contrast-enhanced 64-slice CT can accurately detect and characterize atherosclerotic coronary lesions, according to a study published in the July issue of Journal of the American College of Cardiology. The data signal coronary imaging’s shift in focus from stenosis to coronary plaque.

One of the first studies of its kind has found integrated PET/CT to be a highly accurate method for diagnosing coronary artery disease. Hybrid imaging could become clinically viable in this setting, complement CT coronary angiography, and challenge MRI.

Toshiba has been experimenting for years with a 256-slice CT, developed in collaboration with the Japanese government. Much of the work has been focused on engineering, but clinical studies have begun. Researchers from institutions in Chiba and Osaka, Japan, are producing dynamic images of liver cancer.

Merge eMed unveils fetal 3D packageTwo-D fetal images can be reconstructed in 3D using a plug-in package developed by Cedara Software. The product, called Baby Explorer, is being marketed by Cedara’s parent company, Merge eMed. It runs on a standard PC, supports multiple image types, and exports images that can be printed on standard printers or saved on CD-ROMs.

NeuroLogica wants to fill the gaps left by the surge of new superpremium CTs and advanced SPECT cameras. The 18-month-old imaging company, based in Danvers, MA, has begun building niche products in these two modalities specifically for neurological applications.

Sales of 16-slice CTs led the industry to new heights last year, topping $1.3 billion in new unit sales to U.S. customers. Industry pundits expect even better numbers this year, as all three CT vendors are now in full production with 64-slice products. These units have grabbed the spotlight for their radiological and especially cardiological applications, but they are just the most visible facet of an increasingly complex CT market.

Previous studies have shown that Cry61, a cysteine-rich gene, can induce angiogenesis to improve arterial flow in rabbits with ischemic limb disease. A swine study demonstrated that neovasculature resulting from the infusion of the gene boosts myocardial blood flow to treat myocardial infarction. Nuclear physician Dr. Pascal Merlet and colleagues in the nuclear medicine department of Hopital Bichat in Paris and the cardiology department of Hopital Universitaire Henri Mondor in Creteil, France, performed the experiment.

Few radiologists would disagree that computer-assisted detection in the colon has a long way to go before it is ready for routine clinical implementation. But once the technical challenges have been overcome, advocates for CT colonography screening will have a far stronger case, according to speakers at the Computer Assisted Radiology and Surgery meeting in June.