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Vendors are off to a slow start this year in terms of FDA clearances, managing just 17 in February for a total of 38 for 2006. Only once in the last six years has the industry done worse: In 2004, FDA reviewers cleared just 35 devices in the first two months of the year.

Challenges remain for PET/CT in diagnosing lung cancer. Key among them is bolstering detection without increasing false positives. But in several studies presented at the 2005 RSNA meeting, researchers explored the quantitative data derived by the hybrid technique, and their findings could move PET/CT closer to practical use for this application.

The government plans to spend nearly $800,000 to determine the strategic importance of nuclear medicine research, according to National Institutes of Health chief Dr. Elias Zerhouni. Society of Nuclear Medicine president Dr. Peter Conti is encouraged about the initiative.

No development since I began covering medical imaging in late 1997 has generated the level of excitement and potential for change as the 64-slice CT scanner. Plenty has happened in those years: the flourishing of CAD and virtual colonoscopy, 3T MR and parallel processing, continued advancements in ultrasound, PET/CT and SPECT/CT fusion imaging, and the ascendancy of PACS and imaging informatics.

After installing a 64-slice CT system at Metroplex Hospital in Killeen, TX, radiologists invited asymptomatic referring physicians to undergo a free heart scan and experience the new technology firsthand. After a coronary CT angiogram, three of the doctors left with an appreciation for the new scanner- along with a diagnosis of heart disease.

Among European radiologists, concerns about ionizing radiation exposure give MR an edge in specific applications, including colorectal cancer screening in younger patient populations. But in the U.S., such concerns have not dampened enthusiasm for CT, particularly in neurovascular studies.

Imaging reconstruction software that “unfolds” the colon wall flat could greatly shorten reading time for CT colonography. Researchers from Argentina have found no significant differences in diagnostic accuracy between the “filet view” and conventional CTC in the first study comparing both virtual colonoscopy techniques.

New software from GE Healthcare can cut the average time needed to read a coronary CT angiogram to less than five minutes. Early use at Tennessee Heart and Vascular of the CardIQ Xpress, unveiled March 13 at the American College of Cardiology conference, resulted in physician reviews of 10 to 12 cardiac CTAs per hour.

Business Briefs

Toshiba launches dual-panel system at ACC showAn angiography system that supports both cardiac and peripheral applications debuted March 11 in the Toshiba America Medical Systems booth during the American College of Cardiology meeting. Infinix DP-i/FD2, which incorporates two flat-panel detectors, meets ACC guidelines for both types of applications, according to the company. The system features an 8 x 8-inch floor-mounted cardiac C-arm and a 12 x 16-inch ceiling-mounted C-arm. The design allows coronary and vascular studies on the same table, increasing overall patient comfort and saving time that would otherwise be lost moving the patient to a second system.

The FDA was good to the radiology industry in 2005. For the third time in as many years -- and the fourth in the last five -- the regulatory agency cleared more than 300 radiological products. The last quarter could have been better, however.

CT and MR angiography both provided more clinically useful information than duplex ultrasound in screening peripheral vascular disease. But when costs are factored in, CT emerged as the clear leader, according to a four-hospital study conducted in the Netherlands and described Saturday.

New computer-aided detection programs help less experienced readers find clinically significant polyps with CT colonography, but they prove less useful for experts, according to three studies presented at the ECR on Saturday.

MR colonography has yet to capture radiologists’ imagination to the same extent as CT. But the radiation-free exam has a bright future, especially if stool tagging techniques can avoid the need for bowel cleansing, according to speakers from the U.S. and Greece at ECR on Friday.

Nuclear cardiology has a new heavyweight contender, a gamma camera with a table capacity of 440 pounds, a gantry bore of 27.5 inches, and digital detectors that make the most of tough situations.

The Society of Nuclear Medicine has launched an online learning program that will enable physicians to earn continuing medical education credits and satisfy stricter new certification requirements at their leisure. Registration is now open for oncology PET and oncology PET/CT.

The Society of Nuclear Medicine's recently launched Lifelong Learning and Self-Assessment Program offers online modules to help physicians comply with new maintenance of certification requirements, including 20 nuclear medicine-specific CME credits every year.

Physicians who plan to perform cardiac CT are in for a surprise. Neither radiologists nor cardiologists are qualified to render diagnoses from multislice CT studies without undergoing more training. The supply of qualified teachers and training slots falls far short of the demands of users to learn this new technology.

Before considering revascularization procedures, surgeons want proof of ischemia. While catheter angiography has value in assessing lesions associated with coronary artery disease, it cannot assess the associated ischemia. PET imaging is increasingly being used to provide that information. With the rise of multislice CT angiography as a first-line test for patients with suspected CAD, researchers have set their sights on integrated PET/CT for combined acquisition of coronary anatomy and perfusion.

PET/CT has a promising role in the diagnosis of diabetic foot infections, according to cumulative data by Dr. Zohar Keidar, deputy director of nuclear medicine at Rambam Medical Center in Haifa, Israel.

Contrast agents that can aid MRA examinations have been on the market for more than 15 years. Historically, radiologists could choose from a wide range of agents that, once injected intravenously, would flow through the extracellular space. They would then be excreted from the body relatively rapidly. These extracellular contrast agents are now being joined by a new class of blood pool, or intravascular, contrast agents that bind with molecules in the blood and stay in the circulation for longer.

MR physics dictates that the faster the blood flow, the better the likelihood of quality vessel imaging. Attaining this goal in clinical practice is clearly difficult, given the need for patients to lie still on an MR table for up to 45 minutes. The problem of sluggish blood flow is further compounded in patients with circulatory problems. Yet these are the very individuals who may require MR angiography the most.

After twice considering and rejecting endorsement of CT colonography as a cancer screening tool, the American Cancer Society is taking another look. Prompted by advances in reporting standards, technique, and training, the ACS may include the virtual colonoscopy technique as an optional test in its colon cancer screening guidelines by year's end. Such a move, coupled by favorable results from a national clinical trial, could push CTC into the practice mainstream, bolstering adoption, furthering development of computer-aided detection, and most important, fostering reimbursement.