MRI

This month's cover story ("MR elastography inspires new wave of hepatic imaging," page 20) is devoted to a rare event: the birth of a new imaging modality. MR elastography is a wonder of human ingenuity that employs MRI, a modality that itself still seems like a miracle.

The International Society for Magnetic Resonance in Medicine is geared toward the eggheads of MR: the knob twisters who squeeze as much from their clinical scanners as they can, the experimentalists who push the limits of ultrahigh-field imaging.

Pro-radiology forces are claiming mandated Medicare accreditation as a victory. They will have to wait until January 2012, however, to see the actual implementation of federal law passed in July to mandate accreditation for high-tech medical imaging covered by outpatient Medicare.

In uncertain economic times, there is always one sure thing. Prices are more likely to fall than rise.

No clear winner has emerged in a head-to-head comparison of whole-body FDG-PET/CT and whole-body 3T MRI for non-small cell lung cancer staging. Unenhanced PET/CT proved better for detecting metastatic lymph nodes and soft-tissue involvement, while MR was more sensitive to the presence of brain and liver metastases.

Studies from Korea and the U.S. show that MR imaging of the knee is a reliable and accurate test for the detection of specific subtypes of medial meniscal tears. Good understanding of MR-depicted anatomic features helps identify false-positive injuries of the menisci and avoid unnecessary surgeries.

The U.S. Department of Veterans Affairs has awarded a three-year contract to the American College of Radiology to serve as the accrediting organization for 33 VA hospital radiation oncology facilities across the country.

A metastudy by Australian and European researchers indicates that MR staging identifies additional disease in nearly one of five women previously diagnosed with breast cancer. It also suggests that women may undergo more extensive surgeries than originally planned because of false-positive MR findings.

A novel use of MR has set the stage for neuroscientists to unravel the trillions of neural connections in the human brain and with them a fundamental understanding of brain function and dysfunction.

The RSNA is without doubt the big Kahuna of radiology medical meetings. With 60,000+ attendees and a program book that spans nearly 1000 pages in small type, the fall RSNA meeting sets the agenda for much of what goes on in radiology.

From a pivotal study that may broaden Medicare's acceptance of FDG-PET to Raman spectroscopic techniques that promise a 1000-fold improvement in sensitivity compared with fluorescence imaging, the first half of 2008 will be remembered for fruitful molecular imaging research.

Now that computer-aided detection has become part of routine clinical work for cancer screening in mammograms and is being applied in the differential diagnosis of cancer in the lung and colon, it's only a matter of time before it rates as the standard of care for diagnostic examinations in daily clinical work.

Later this year, Carestream Health will release for testing a PACS algorithm that automatically registers several data sets, synchronizing slices to allow comparison of present and prior CT and MR exams. By early next year, this capability is expected to be at the fingertips of Carestream PACS owners.

Women with uterine fibroids remain in the dark about the potential benefits of uterine artery embolization more than a decade after the development of the nonsurgical treatment. Specialists contend that both ob/gyn providers and interventional radiologists should intensify efforts to educate women with the condition about their treatment options.

Screening ultrasound paired with mammography improved breast cancer detection in high-risk women, but the combination also caused a spike in the number of false positives, according to an update to the American College of Radiology Imaging Network 6666 trial. These results may render ultrasound less attractive than MRI in this patient population.

Dr. Henry J. Wagner Jr. has selected two images, a PET/CT scan showing the early metastatic spread of tumor in a patient’s ear and a SPECT/MRI study of osteomyelitis in another patient’s foot, to exemplify the diagnostic capabilities of nuclear medicine as the 2008 Society of Nuclear Medicine Image of the Year.

One of the most intriguingly named scientific sessions at this year's ECR was Fat radiology You might think this consisted of a series of preaching-type lectures about how and why the profession has never had it so good. In fact, speakers from the Irish Republic and the U.S. focused on the implications of the growing number of obese patients for radiologists and clinicians and discussed whether more could be done to optimize imaging of this group.

Primary malignant musculoskeletal tumors are an inhomogeneous group of lesions originating from mesenchymal tissues.

A status report on nephrogenic systemic fibrosis suggests that new cases of the rare but devastating skin disease associated with exposure to gadolinium-based MRI contrast media have slowed to a trickle since the introduction of regulatory restrictions in the U.S. and Europe in 2007.

Teleradiology is playing a significant role in a major three-year international trial focused on sickle cell disease.

A little diffusion imaging goes a long way toward boosting the accuracy of whole-body MRI and matching the performance of whole-body FDG-PET/CT for M-staging of non-small cell lung cancer.

Diastematomyelia case study: A 40-year-old man with upper and lower back pain. He denied any bowel or bladder dysfunction, radiating symptoms, or motor deficits.

Interventional radiologists, like their diagnostic counterparts, remain under pressure as payers ratchet back reimbursements. But they continue to fight on the reimbursement front and see some silver linings in new government programs designed to improve the quality of care.

Necessity is not always the mother of invention. If you are Dr. Roderic Pettigrew, director of the National Institute of Biomedical Imaging and Bioengineering, invention can germinate from any number of sources. The likelihood of its ultimate adoption increases with the help of federal funds and the guidance that comes from an interdisciplinary approach to medical research and development.

Posterior fossa anomalies detected on fetal MR imaging should be confirmed with postnatal imaging, according to a study in the June American Journal of Roentgenology. Investigators from the U.S. and Canada found significant discrepancies between fetal and postnatal posterior fossa findings on MRI.

Advanced gradients and parallel imaging, along with ergonomic features, combine to boost productivity A new 3T scanner unveiled last month by GE Healthcare delivers unprecedented speed and resolution in some of the toughest areas of the body to image. Combining advanced parallel imaging software with powerful gradients and an optical radiofrequency transmit system, the MR750 can complete high-resolution liver exams in 15 minutes, according to the company.

A casual attitude toward keeping track of gadolinium-enhanced studies may come back to haunt radiology departments that become involved in several federal lawsuits alleging a connection between cases of nephrogenic systemic fibrosis and gadolinium-based MR contrast agents.

With piles of accumulated evidence demonstrating the ability of multislice CT to diagnose coronary artery disease, researchers are expanding clinical application of the modality to the measurement of myocardial viability following infarction.

News of Sen. Edward Kennedy’s diagnosis with a malignant glioma shocked the nation. It has also raised awareness about the grim prognosis associated with this type of brain tumor. A new study conducted by the American College of Radiology’s Radiation Therapy Oncology Group could bring hope to glioma patients.

When it comes to getting respect, radiologists are apparently the Rodney Dangerfield of the medical profession.