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The most highly anticipated stroke imaging trial of the year has left radiologists scratching their heads about the disappointing results. No more than 47% of acute stroke patients administered the clot-dissolving protein desmoteplase three to nine hours after the onset of symptoms showed improvement. The positive outcome rate was about the same among patients given a placebo.

Radiologists could be shortchanged if Medicare goes through with plans announced Monday to end its long-standing policy of paying separately for imaging contrast media, radiopharmaceuticals, interventional radiology supervision, and interpretation.

Myriad Genetics is the only place to go for BRCA1/BRCA2 mutation testing. The Salt Lake City biopharmaceutical company has a monopoly on the test. Its scientists discovered the BRCA1 and BRCA2 genes in 1996 and patented their use for assessing the risk of genetically related cancer.

Like other medical journalists, I can usually be found in the front rows of the radiology meeting lecture halls, dutifully taking copious notes. The American Roentgen Ray Society meeting in May was no exception. But this time I was also under a vow of silence for three weeks, after a vocal cord nodule diagnosis.

Case Of The Month

Back pain and weakness of both legs had bothered this 60-year-old woman for one week. Left breast cancer, stage 2, had been diagnosed two years before, and she subsequently underwent a lumpectomy followed by chemotherapy and radiation therapy.

In a flash, after the American Cancer Society guidelines came out in favor of breast MRI for high-risk screening in late March, prominent radiology preauthorization company CareCore proclaimed it had been ahead of the times. The ACS release was a major coup for the technique.

An influential trial has left neuroradiologists in a quandary about the best imaging approach for the initial evaluation of acute stroke. The single-center prospective trial concluded that MRI accurately diagnoses acute stroke while noncontrast CT, the old gold standard, is about as accurate as a coin flip.

Monty Python, the British comedy troupe, got it at least partially wrong. Contrary to the claim of their legendary skit involving Catholic cardinals, a matronly lady, and torture in a comfy chair, one can expect the Spanish Inquisition. An Albequerque oncologist has found evidence of Spain's infamous campaign to rid itself and its territories of heretics by testing Hispanic women in northern New Mexico for BRCA1/BRCA2 mutations.

A new web-based automated mail and phone system that helps medical secretaries remind women to schedule a mammogram could boost breast cancer screening rates, according to Mayo Clinic researchers.

Some women who carry a strong genetic susceptibility to cancer have consented to the surgical removal of their breasts to avoid likely cancer. The combination of reliable genetic testing, however, and close surveillance using breast MRI, mammography, and ultrasound now offers an alternative to such excision or the acceptance of a strong possibility of cancer.

Dr. Susan Bookheimer and colleagues at the University of California, Los Angeles have confirmed through functional MRI 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 2007 International Meeting for Autism Research.

With the incidence of arthritis and other musculoskeletal diseases set to double in the next two decades, clinicians will welcome new quantitative 3T MRI strategies for assessing cartilage and chondral lesions.

Many problems associated with the gastrointestinal tract occur in young patients. The use of repeated CT scans to evaluate these patients over the course of years is questionable, however, given the repeated exposure to ionizing radiation. MRI is proving to be a reliable tool to image the small bowel as well as the colon, according to Dr. Thomas C. Lauenstein, an assistant professor of radiology at Emory University.

How much would you pay to avoid spending the rest of your life in prison: $2 million? How about 30 years in prison: $1 million? Even if we lowball it and say a radiologist makes about $250,000 a year, 30 years of your life would be worth more like $7.5 million. What if I told you it would cost you only $10,000. A steal, right?

Groin pain, whether acute or chronic, is a common clinical presentation that can be caused by a diverse array of disorders involving different anatomic structures. This makes definitive diagnosis difficult for even the most experienced clinician. Imaging can be invaluable in both localizing and characterizing otherwise uncertain groin pathology.

Alzheimer’s disease researchers may be able to reduce the time and expense associated with clinical trials, according to early results from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), a public-private research partnership organized by the National Institutes of Health.