CT

Coronary CT angiography has proven to be a boon to radiologists and cardiologists in private practice. With a high negative predictive value, it can easily rule out coronary artery disease in patients with nondiagnostic electrocardiograms. For cardiologists in particular, CTA can help offset declining reimbursements associated with catheter procedures and nuclear medicine tests. But some cardiologists resist.

Being a specialist in cardiovascular imaging, I have followed the development of cardiac topics at the ECR since 1991. Tremendous changes have occurred over this period.

For the third year running, editors from Diagnostic Imaging have landed in Vienna to provide Webcast coverage of the European Congress of Radiology. Although the RSNA is becoming more international every year, it can’t capture the unique European perspective presented at this annual event. Our daily news stories will highlight research from the studies presented at the ECR, but much more is available at the Webcast.

The Integrating the Healthcare Enterprise initiative continued throughout 2004 to round out its blueprint for designing interoperable systems and products, creating new supplements and integration profiles. Radiology-centric portable data, nuclear medicine profiles, and several additions to the scheduled workflow profile topped the list. The IHE also tackled the electronic health record with the introduction of the cross-enterprise document-sharing integration profile.

Whole-body scans are a snap. Efficiently reading them is not.

Enter Ripley’s Odditorium on the Web, and you are greeted by the man who smokes through his eye, the human plank, Fire Eater, and Rubber Man. These are not the sort of folks most people meet in their daily lives. They establish Ripley’s Believe It Or Not as the world’s authority on unbelievable, odd, weird, and unusual things.

The extraordinary capabilities of cardiac CT are drawing increased attention from cardiologists, who long ago conquered angiography, echocardiography, and cardiac nuclear medicine. That interest concerns radiologists, who worry about the potential for self-referral, inappropriate utilization, and lost turf.

Integrating a profusion of digital healthcare information systems is central to providing efficient, high-quality healthcare, and this need spans national boundaries.

The Society of Nuclear Medicine recently added the tagline “advancing molecular imaging” to its logo. Now it is developing a center of molecular imaging in an effort to disseminate information and promote research in the rapidly advancing field.

The industry ended the calendar year with a flurry of FDA clearances, easily topping last year’s total and establishing a new high for the decade.

No other company has done what GE has done: The merger of its medical systems unit with British pharmaceutical giant Amersham combined a multimodality maker of imaging equipment with the manufacturer of contrast media.

Maintaining order in the rapidly changing, sometimes contentious development of cardiac CT imaging may have become easier. Last weekend, two independent groups met in two U.S. cities to establish two separate professional societies geared toward promoting the clinical use of cardiac CT angiography.

PET/CT stepped up to 64-slice scanning, while many visitors to the RSNA meeting got their first close-up look at the next generation of gamma cameras. Hybrid SPECT/CT was first publicly seen in June 2004 at the Society of Nuclear Medicine meeting.

CT vendors delivered on promises made a year earlier with the delivery of 64-slice scanners. As the RSNA show floor opened, each of the four major vendors -- Siemens, GE, Philips, and Toshiba -- was either shipping these megaslice scanners or planning to begin doing so in early 2005. The offerings, however, were anything but homogeneous. The differences became apparent in each company’s presentation of its products and discussion of its competitors.

CT vendors were exceptional in their predictability, as each bore product pathways to the RSNA meeting as true as rifle shots. High-end and midtier scanners appeared on cue, their makers registering claims for their own products and criticism of the competition. It all came as little surprise to anyone familiar with the RSNA exhibit floor.

Virtual colonoscopy took a roller coaster ride last year. Some peer-reviewed studies touted the technique, while others favored conventional colonoscopy. Experts on each side complained of flaws in the other side's methodology. With that background, an international working group has developed a standardized reporting system for CT colonography.

Hybrid imaging dominated the nuclear medicine section of the RSNA exhibit floor. Philips and Siemens promoted multislice SPECT/CT, while GE, which pioneered the idea five years ago, showed an upgraded version of its Infinia gamma camera coupled to a single-slice, nondiagnostic CT for attenuation correction.

Radiologists eagerly expecting a clear winner to emerge from the RSNA session on CT colonography interpretation technique walked away disappointed Tuesday afternoon. A series of four presentations provided no clear consensus on which method would increase sensitivity for polyp detection.

Hybrid imaging dominates the nuclear medicine section of the RSNA exhibit floor. Philips and Siemens are promoting multislice SPECT/CT, while GE, which pioneered the idea five years ago, is showing an upgraded version of its Infinia gamma camera coupled to a single-slice, nondiagnostic CT for attenuation correction.

Perforation rates for a CT colonography, while still low and acceptable, are fast approaching those of traditional optical colonoscopy.

Proponents of CT colonography may lower the bar in measuring the imaging modality against conventional colonoscopy. After a wave of mediocre sensitivity results, many experts are asking whether it should be compared instead with optical colonoscopy or air contrast barium enema.

PET pioneer acquires micro-CT firm CTI Molecular Imaging plans to acquire ImTek, a provider of micro-CT systems for imaging laboratory animals used in medical research. The $3.75 million cash deal is expected to close by the end of November. Financial performance and milestone achievements hold the potential for future incentive payments. The acquisition of ImTek, which designs and manufactures the MicroCAT scanners, would complement CTI Concorde, a business unit of CTI Molecular Imaging dedicated to the manufacture of micro-PET scanners.

CT angiography can identify patients with subclinical atherosclerosis who may be inaccurately diagnosed as normal by traditional catheter angiography, according to a study from South Carolina.

Providing attenuation correction in SPECT/CT is no longer enough for GE Healthcare. The company that pioneered hybrid imaging five years ago with its Hawkeye Infinia will release a multislice version of the system a few weeks from now at the RSNA meeting. The reason is not so much the market as GE’s competitors.

A lull enveloped September, as FDA reviewers cleared just 25 new radiological devices -- a slight dip from August and well below the earlier summer months, which rode into the high 30s. The industry was still well ahead of last year, however, in the total number of devices cleared for marketing in the U.S.

Radiology's cardiac turf losses are legion: cardiac catheterization, cardiac angioplasty, echocardiography, and nuclear cardiology. Today, another turf battle is taking shape: control of cardiac CT and MR.

Taking a cue from breast imaging, an international working group has developed a standardized reporting system for CT colonography. The step could help it win wider acceptance as a screening strategy for colon cancer.