MRI

A Georgetown University researcher has established a link between block time and per-click leasing arrangements and physician self-referral for high-tech imaging billed to a large healthcare insurer in California.

More is better and all but inevitable in medical imaging. In CT, more means slices. In MR, it’s channels for receiving radiofrequency signals. These currently number 32 on the most advanced commercially available systems. But a replacement for that benchmark is in the works.

Before the dawn of political correctness, there was a time when girls were made of sugar and spice and everything nice, and boys were made of snips and snails and puppy dog tails. Now, functional MRI is confirming that boys and girls really don't think alike. Brain structures and functions that facilitate intelligence in girls are different for boys.

Whole-body diffusion-weighted MRI has been introduced to complement and possibly compete against whole-body FDG PET and whole-body anatomical MRI for staging cancer metastasis.

Functional MR scans have confirmed that levels of brain function are low or nonexistent in autistic patients viewing stimuli designed to provoke emotional activity, according to studies presented at the International Meeting for Autism Research held in early May in Seattle.

Playing off the continuously moving table built into TimCT, Siemens Medical Solutions proclaimed “Tim (Siemens’ total image matrix) is on the move” at the International Society for Magnetic Resonance in Medicine meeting in Berlin. The company is featuring clinical results from its seven luminary installations of the technology in MR angiography and central nervous system imaging.

Volumetric and highly specialized imaging techniques will expand the clinical horizons of MR, according to GE Healthcare. Technologies that improve the speed of data acquisition and processing will make them practical.

Toshiba Medical Systems Europe is going toe-to-toe with the established high-end vendors at 1.5T during the International Society for Magnetic Resonance in Medicine meeting in Berlin. Its high-performance Vantage Atlas MR, shown several months earlier at the RSNA meeting as a work-in-progress, became a commercial reality with the first system installed and operating in March at a hospital in a Paris suburb and another more recently at an outpatient facility in Las Vegas.

An Emory University researcher has established the diagnostic power of a simple contrast-enhanced MRI protocol that informs surgeons about the presence and extent of hepatocellular cancer in cirrhotic livers that are scheduled for transplantation.

Within two weeks this month, Berlin will have played host to two major and one very small radiological meeting. The German Roentgen Society has just left Berlin’s International Congress Center, and the combined International Society for Magnetic Resonance in Medicine (ISMRM)/European Society for Magnetic Resonance in Medicine and Biology (ESMRMB) is gathering. At the end of this week, the 25th anniversary meeting of the European Magnetic Resonance Forum (EMRF) will take place at Cecilienhof Castle in Potsdam, some 20 km away.

Unlike tests that provide thresholds such as good or bad cholesterol levels, MR scans are open to interpretation. Early steps toward quantitation have focused on measuring tumor size and volume as indicators of cancer progression or patient response to therapy. Philips is going further.

The differing interests of clinical and basic science researchers are apparent in the work of the finalists for Young Investigator Awards at this year’s ISMRM/ESMRMB meeting.

No topic can dominate a conference as dynamic as the annual meeting of the International Society for Magnetic Resonance in Medicine. But with many experts chiming in on nephrogenic systemic fibrosis, the subject will be a focus of the society’s jointly sponsored conference with the European Society for Magnetic Resonance in Medicine and Biology starting Monday in Berlin.

A review of the current literature reveals a difference of opinion regarding whether to screen diabetic patients with CT and an inherent flaw with hybrid SPECT/CT scanners resulting in misregistered images. Researchers also optimized a contrast protocol for the triple rule-out procedure and advise echo studies when mitral valve calcification is found on chest CT.

Most orthopedic implants are made from nonferromagnetic materials and, therefore, tend to be acceptable for patients undergoing MRI examinations. In vitro testing conducted at 1.5T and 3T has verified the safe aspects of orthopedic devices with regard to magnetic field interactions (see www.MRIsafety.com for a summary of this information).

Most U.S. breast specialists are performing contrast-enhanced breast MRI, albeit at a fairly low volume, according to a survey presented today at the American Roentgen Ray Society meeting in Orlando. About one-third of facilities performing breast MRI do not offer MRI-guided biopsies as well, however.

Three-D MR imaging has led to new insights concerning the relationship between dysfunctional gray matter and the physiological effects of lithium therapy for bipolar disorders. The findings were reported in April in an online version of the journal Biological Psychiatry.

Practitioners can choose either vertebroplasty or kyphoplasty to treat vertebral compression fractures until a prospective trial comparing the two techniques says otherwise, according a multisociety position statement in the Journal of Vascular and Interventional Radiology. The statement does not fully address the economic impact of each treatment choice.

Lower costs, speedier recovery, and reduced pain give uterine artery embolization an edge over surgery for fibroid treatment, according to a multicenter trial that examined the relative merits of the two methods.

Correct diagnosis of tumor character and stage is fundamental to lung cancer therapy planning, but evaluating indeterminate solitary pulmonary nodules continues to challenge radiologists. It is vital to determine as soon as possible, however, whether patients are likely to respond to treatment.

Dementia affects between 1% and 6% of people over the age of 65 and 10% to 20% of those over 80. As more and more individuals survive into old age, the absolute number of dementia sufferers is likely to soar.

MRI has great value in guiding treatment of breast cancer patients and is well worth the extra expense when used appropriately. Accurate assessment of the extent of disease prior to breast surgery is essential if inappropriate procedures and repeat conservation surgeries are to be avoided, according to speakers at ECR 2007.

Not all those who suffer heart attacks have typical symptoms. Many people, including the elderly, those with renal disease, and women, are at risk of having a silent myocardial infarction.

MRI can be daunting enough for claustrophobic patients. But now arachnophobia may be a good reason to fear entering the tube. Researchers have begun studying large eight-legged creatures with clinical MR systems (Magn Reson Imaging 2007;25:129-135).

Diagnosing pancreatic disease generally requires many different imaging procedures. Ultrasound and CT are most commonly used to evaluate the pancreatic ducts, parenchyma, and adjacent soft tissues. CT-based assessment of pancreatic pathology has been greatly aided by the advent of multislice technology.

MRI will continue to evolve and will remain the dominant imaging technology in medicine, according to a leading world expert on the modality.

In late November, nearly 300 doctors and imaging center managers paid $325 each for a day-long seminar sponsored by the law firm McDermott Will & Emery. They packed a large ballroom in the swank Ritz-Carlton Hotel at Water Tower Place in Chicago to learn how to turn referrals to imaging facilities into lucrative income streams.

Peripheral MR angiography (far right) is improved on first-pass imaging due to the high relaxivity of the MR blood pool agent Vasovist. The extended imaging window provided by the agent supports steady-state imaging not possible with other MR contrast media, producing ultrahigh spatial resolution MRA (second pass) demonstrating both arteries and veins in detail.

Whole-body MR imaging could complement-and, in some cases, even replace-traditional bone scanning techniques. Researchers across Europe have found that whole-body MRI has a significant impact on patient management compared with x-ray and nuclear medicine.

Striking the right balance between quality and throughput is never easy, especially when the queue of referrals seems never to end. Shorter scan times mean that another patient or two could be squeezed onto the day's work list.