MRI

I recently completed a task that we expect will lead to a more refined search engine for the Diagnostic Imaging Web site and those of our sister publications at CMPMedica. The project required perusing some 400-plus articles in the radiology literature from the past 30 years, covering every conceivable subcategory, and tagging those that best define each clinical application and modality. It involved some tedious parsing of wheat from chaff but provided ample opportunity for reflection on how far radiology has come.

Two investigative studies have found that MR angiography at 3T produces quality images of the kidneys and excellent cardiac cine images. Researchers used high parallel imaging factors and a 32-element phased-array coil to increase spatial resolution and anatomic coverage.

Urinary bladder carcinoma is the second most common malignant tumor in the urogenital tract. This cancer causes 5000 deaths each year in Germany and 10,400 in the U.S., affecting men more often than women. The patient population is predominantly elderly, with a mean age of 70 years old.

Technology Update

Like an expanding bubble, the number of MR applications continues to rise exponentially. Looking back over the last 27 years, I see several major MRI epochs: low- to midfield systems (late 1970s to mid-1980s), 1.5T with 10 mT/m gradients (mid-1980s to mid-1990s), and 1.5T with echo-planar gradients (mid-1990s to early 2000s). We entered a new epoch a few years ago: 3T with echo-planar gradients. Examining changes currently occurring, and understanding why they occur, can help us predict further changes to come over the next decade.

Researchers may agree that cardiac MR is the modality of choice for predicting left ventricular remodeling, but they are split on which contrast-enhanced CMR technique produces the most accurate prediction, as the conclusions of studies presented at the RSNA meeting show.

Move over MRI and ultrasonography: 64-slice CT is staking a claim in assessment of tumor extent in patients with locally advanced breast cancer ahead of conservation surgery.

Radiologists perform most diagnostic and minimally invasive interventional musculoskeletal studies in the U.S., with some areas experiencing continuous growth. Data released Wednesday at the RSNA meeting, however, suggest future turf battles between radiologists and surgeons are lurking on the horizon.

The Molecular Imaging Zone, a new feature of the RSNA meeting, gives radiologists a chance to learn how molecular imaging applies to their current and future practice.

Positional MRI, which allows patients free range of motion during imaging, has allowed researchers to determine the optimal sitting posture to reduce chronic back problems. The technique may also be of value in future seating design.

Use of breast ultrasound and breast MRI in Medicare beneficiaries has been on the rise, but mammography utilization has not kept apace. Following a big boost in the number of mammograms in the late 1990s, growth has slowed in recent years. The reason could be waning awareness of screening programs or possibly a decline in access due to center closures.

Positional MRI, which allows patients free range of motion during imaging, has allowed researchers to determine the optimal sitting posture to reduce chronic back problems. The technique may also be of value in future seating design.

Although MR colonography (MRC) is proving to be an effective method of colorectal screening, patients are no more likely to accept it than optical colonoscopy, according to two studies presented at the RSNA meeting.

Aurora Technologies will begin routinely upgrading its installed base of about 20 dedicated breast MR scanners with an acquisition capability that boosts signal-to-noise by 300%, according to the company. The upgrade, called spiral RODEO (Rotating Delivery of Excitation Off-resonance), was commercially launched at the RSNA meeting.

MR peripherals maker Resonance Technology introduced at the RSNA meeting its new FuncLAB functional MRI system with automated image data processing. FuncLAB presents functional imaging tasks using high-quality 3D graphics and audio with an automated data processing component that eliminates complex, time-intensive manual data analysis. The server for processing fMRI data attaches to the department network. Functional and anatomic images are automatically sent in DICOM format from the scanner to the processor. Resulting brain maps of anatomy fused with functional results are available onsite and over the Web through a browser-based interface.

Continued concerns over breast MRI’s clinical cost-effectiveness can be fully addressed only if radiologists can reach a consensus on the appropriate indications and development of standard protocols, according to New York-based researchers.

Officials from the American College of Radiology and the American College of Cardiology, along with other interested stakeholders, have published a consensus report defining quality for all cardiovascular imaging modalities. They say that the focus on quality in cardiovascular imaging has been less intense than in other areas of cardiovascular medicine.

Particles one-billionth of a meter in size can be loaded with high concentrations of drugs designed to kill brain cancer. These nanoparticles can be used to image and track tumors as well as destroy them, according to researchers at the University of Michigan Comprehensive Cancer Center.

One drawback of cardiac MRI is the creation of motion artifacts from the beating heart and patient breathing. Researchers in Japan have found that these artifacts can be reduced when images are collected during systole rather than diastole.

A study at UCLA looks at milestones in the development of cardiac MR. A large-scale study finds no difference in thrombosis rates between bare metal and drug-eluting stents. A study at Massachusetts General Hospital confirms that multislice CT can eliminate unnecessary hospital admissions by ruling out myocardial infarction for patients with chest pain who have nondiagnostic ECG results and normal cardiac enzymes.

Problems with gadolinium-containing contrast agents administered to patients with renal impairment are more common than originally estimated. The lack of awareness among radiologists about the potential dangers for those at high risk is striking, according to researchers.

When a smoker takes one puff of a cigarette, about 30% of the brain's most common nicotine receptors are affected. With three puffs, the nicotine in the cigarette occupies about 70% of the receptors. The smoker becomes satisfied when nearly all of the receptors are occupied, usually after smoking about three cigarettes.

Step-by-step checklist should enable differentiation of pathology even on plain film x-ray

Elderly patients can undergo CT scanning of the pancreatobiliary region with only 90% or less of the contrast dose required in other patients without compromising the exam's quality.

Neuroimaging research has contributed enormously to our understanding of structural and functional differences between the brains of people with schizophrenia and those of healthy people. Imaging now offers insights into how drugs used to treat schizophrenia work as well as the genetic mechanisms that lie at the root of these disorders.

After 19 years in a minimally conscious state, a man recovered language and motor function. Diffusion tensor imaging showed reorganization of the patient's white matter, possibly facilitating functional recovery.

Ovarian cancer accounts for nearly 3% of all cancers among women. It is the second most common gynecological malignancy in the U.S., following carcinoma of the uterine corpus.

MRI performed at an unlimited specific absorption rate is safe in patients with some permanent pacemakers or implantable cardioverter/defibrillator systems, as long as precautions are taken, according to a study from Israel.

In rectal cancer, mortality rates are high and prognoses are generally poor, owing to the strong risk of metastases and local recurrence.