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Trails blazed in medicine often bring controversy and even consternation. Breast care is no different. Since 1965, when the American College of Radiology formed the Committee on Mammography, advances in breast imaging and legislation to ensure its quality have largely centered on x-ray mammography.

If patients suffering from malignant disease are to get the right treatment and an accurate prognosis, accurate assessment of metastases is crucial. Whole-body MR is a good tool that can play a supporting role for detection of metastases, but it is not as reliable as gold standard PET/CT, according to research presented at the European Congress of Radiology.

Technical advances in MRI have paved the way for functional imaging of the abdomen, moving beyond simple morphological evaluation of disease and in sometimes proving superior to multislice CT. With quantitative imaging tools at their disposal, radiologists are rethinking what they need to visualize with MR to answer new clinical questions.

Journal Review

March was a month of notable progress for cardiac MR, with studies demonstrating the impressive prognostic power of adenosine stress perfusion and dobutamine stress wall motion imaging. The combination was nearly perfect in identifying patients who would be safe from cardiac death or myocardial infarction for at least three years. Recent cardiac imaging studies also affirm fusion imaging’s value for diagnosing coronary artery disease.

Imaging is poised to play a key role in the advancement of 21st-century science and healthcare, but only if the radiology community changes its view of imaging sciences, according to Dr. Elias Zerhouni, director of the National Institutes of Health. If that means researchers adopting unconventional or innovative approaches, so be it.

Imaging is poised to play a key role in the advancement of 21st century science and healthcare. This will happen only if the radiology community changes its view of imaging sciences, according to Dr. Elias Zerhouni, a radiologist and director of the National Institutes of Health. And if that means researchers adopting unconventional or innovative approaches, so be it.

Technological advances to CT and MRI allow radiologists to perform whole-body examinations in mere seconds. This has changed the way radiologists use whole-body imaging in diagnostics, according to Dr. Maximilian Reiser, director of the Institute for Clinical Radiology at the Ludwig-Maximilian University in Munich and incoming 2008 president of the European Congress of Radiology.

Technical advances in MRI have paved the way for functional imaging of the abdomen, moving beyond simple morphological evaluation of disease and in some cases proving superior to multislice CT. With quantitative imaging tools at their disposal, radiologists are rethinking what they need to visualize with MR to answer new clinical questions.

Sonoelastography shows strong performance in prostate cancer detection, but room for improvement remains when it comes to specificity, according to research from the Medical University Innsbruck in Austria, a leading center in prostate imaging research.

In conventional imaging, stable and dangerous lesions have a similar appearance. But new techniques using contrast-enhanced high-resolution MR molecular imaging can help to determine when to treat atherosclerotic plaques and when to leave them alone, according to a Saturday minicourse on molecular imaging.

Bone marrow edema produces characteristic alterations in signal (low on T1- and high on T2-weighted MR images), but its pattern of presentation is highly nonspecific, posing a challenge for radiologists. Edema-like bone marrow patterns generally are reflected by ill-defined increased signal changes on fluid-sensitive sequences such as short-tau inversion recovery or fat-suppressed T2-weighted.

At last year’s European Congress of Radiology, research regarding 64-slice CT angiography was focused on its feasibility. This year, feasibility is no longer an issue. Rather, a wealth of evidence is being presented attesting to the fact that coronary CTA is a powerful and useful tool to evaluate patients suspected of coronary artery disease who are at intermediate risk. It is within this niche patient group -- those who would otherwise undergo invasive catheter angiography -- that coronary CTA is finding an affordalbe home.

Around 10% to 15% of patients in the developed world die following acute stroke, 30% to 60% survive with long-term disabilities, and 20% to 25% require a hospital stay. These frightening statistics could be improved if radically different strategies were adopted for managing stroke patients, according to speakers at an overflowing state-of-the-art symposium.

MR imaging has great value in guiding treatment of breast cancer patients and is well worth the extra expense when used appropriately, according to radiologists speaking at an ECR session on Sunday.

Patients with compressive or entrapment neuropathies of the elbow, forearm, wrist, or hand may go straight to sonographic examination. In skilled hands, ultrasound can produce images that reveal pathology as well as MR images can. But while the diagnosis of a tendon rupture is a relatively simple matter with ultrasound, to assess specific neurological injuries, such as nerve entrapment and compression, the technique requires considerable experience, expertise, and patience, said Dr. Javier Beltran of the Maimonides Medical Center in Brooklyn, NY.

In treating an underlying problem in the head and neck, potential complications must be identified and graded in the radiologist’s report for correct follow-up. Radiologists may be able to solve a clinical problem directly with a single approach such as ultrasound. But other modalities must be used when ultrasound fails due to the depth of a lesion or air within the lumen, making evaluation of the head and neck complex, according to researchers from Italy, Austria, and Switzerland.

If patients suffering from malignant disease are to get the right treatment and an accurate prognosis, accurate assessment of metastases is crucial. Whole-body MR is a good tool that can play a supporting role for detection of metastases, but it is not as reliable as gold standard PET/CT, according to research presented on Saturday.

Functional MRI is increasingly being used preoperatively to improve the safety of surgery that will remove brain tumors or locate epileptogenic foci by mapping motor, somatosensory, and language functions, at least in larger teaching and university hospitals.

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