MRI

Primary malignant musculoskeletal tumors are an inhomogeneous group of lesions originating from mesenchymal tissues. Soft-tissue sarcomas can derive from fatty tissue (liposarcoma), muscles (leiomyosarcoma, rhabdomyosarcoma), connective tissue (fibrosarcoma), blood vessels (angiosarcoma), and neurogenic tissue (malignant peripheral nerve sheath tumor, malignant schwannoma).

Office released a major report on the growth of Medicare Part B imaging services at the same time the Centers for Medicare and Medicaid Services issued sweeping rules that target self-referred imaging services.

MR neuroimaging research has found that cognitive processes relating to verbal fluency are compromised in people with insomnia despite the absence of a behavioral deficit. These specific brain function alterations can be reversed, however, through nonpharmacological treatment with six weeks of sleep therapy.

Although both gadobenate dimeglumine and gadodiamide are gadolinium-based agents, the former provides more conspicuous enhancement for imaging of brain lesions, according to results from an international multicenter trial. Findings could lead to further improvements in the management of these patients.

The attention of the medical imaging community looks set to turn to Seoul later in October, when the 12th Asian Oceanian Congress of Radiology will be held. This is the first time the congress has been staged in Korea since its debut event in 1971, and, given the high quality of radiological practice within the country and its strong educational links with the U.S., the conference is bound to attract plenty of interest. The number and expertise of the invited speakers from North America are certainly impressive.

A novel MRI technique that tracks naturally occurring polymers in cartilage can lead to the diagnosis of early-stage osteoarthritis and may lead to better drug treatment and a reduction in the need for joint replacement surgeries.

Susceptibility-weighted MR imaging provides high-resolution, distortion-free blood oxygen level-dependent data for assessment of cerebral veins, blood products, and brain lesions. Currently, however, reconstruction of susceptibility-weighted imaging data is not implemented on all MR systems.

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.

Coronary heart disease is one of the leading causes of morbidity and mortality in developed countries.1 Accurate detection of early cardiac disease is of utmost importance for the delivery of appropriate treatment.

The era of postautopsy confirmation of Alzheimer’s disease may be coming to an end. MR imaging could spot signs of brain deterioration predictive of cognitive decline months, even years, before the onset of dementia, according to recent studies performed in Canada, Europe, and the U.S.

Multislice CT angiography should be the preferred choice over MR angiography or duplex ultrasound for initial evaluation of patients with suspected peripheral arterial disease.

Multislice CT is just as accurate as MRI in assessing myocardial infarct size in an emergency setting, according to a recent study conducted by researchers in France and the U.S. The latest data validate previous findings suggesting delayed-enhancement myocardial CT correlates well with measures of infarction size done with cardiac MR.

MR imaging can be used for many applications in oncology. Its main roles in cancer imaging are determining locoregional tumor extent, characterizing tumors, and monitoring treatment. MRI, like CT, relies on morphological criteria for lesion differentiation. This reliance, however, can make it difficult to detect small cancerous deposits and to differentiate tumor recurrence from treatment-induced tissue changes.

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.