CT

"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.

Opponents of the government's plans to reduce technical payments for cross-sectional imaging of contiguous body parts and to apply the self-referral laws to nuclear medicine have until the end of this month to voice their disapproval.

Sixty-four slice CT makes all things radiologic better. The high spatial and temporal resolutions that work so well for cardiac imaging also improve other applications, especially vascular studies.

The ability to simultaneously display 3D anatomic and molecular information to evaluate lung cancer earned recognition from the Society of Nuclear Medicine in its choice of image of the year.

Electron-beam CT angiography topped catheter angiography in determining the most at-risk adult patients with congenital coronary artery defects. Although both techniques showed the anomalies, EBCT better depicted the proximal course of anomalous vessels, according to a small study from Turkey reported in the September issue of Catheterization and Cardiovascular Interventions.

July saw just one more FDA clearance (24) than the previous month, but the number of sophisticated submissions took a sharp turn to the north. Devices in image management and CT promise interesting twists on established offerings, while others in nuclear medicine, ultrasound, and x-ray indicate expansions of some vendors’ product lines.

China’s increasing demand for modern healthcare innovations has given a welcome boost to the makers of medical imaging equipment. With no sign of a slowdown in growth, it is little wonder that Siemens Medical Solutions is ramping up its investment in this market.

Usually, the beginnings of great change are recognized only in hindsight. The exception to that rule may have happened Aug. 24. This was the day the developers of Cell Broadband Engine Architecture -- known informally as Cell -- flung wide the doors to the technical underpinnings of this new computing chip.

Researchers in Japan have tested a prototype 256-slice CT scanner in human patients, according to a study in the July issue of the American Journal of Roentgenology. The technology enabled dynamic imaging of liver cancer in real-time.

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 Computer Assisted Radiology and Surgery meeting in June.

The fusion of anatomic and functional data in PET/CT scans has received an enthusiastic welcome from both radiologists and nuclear medicine physicians. The combination of modalities has benefited oncology in particular. The use of new radioisotopes and ligands will broaden the scope of PET/CT in diagnosis, therapy, and clinical research, according to Prof. Peter Ell, director of the Institute of Nuclear Medicine at University College London.