MRI

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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.

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.

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.

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.

Europeans are advised to follow steps outlined in the U.S. to prevent a life-threatening skin condition linked with gadolinium-enhanced MRI or MR angiography, according to a new editorial in European Radiology. The article stresses the importance of caution in high-risk patients for all gadolinium agents, not just the ones that have been associated with reactions, because the condition’s causes are still unclear.

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.

MRI has proven to be a reliable, fast, noninvasive means for assessing deep fat in adults. It can also be effective in high-risk pre-adolescents and adolescents, according to a study in the March issue of Radiology.

Advances in coil technology and the development of tailored sequences have made 3T a versatile alternative to 1.5T. But it will be a long time until it displaces 1.5T as the workhorse of MR.

Journal Review

Recently published studies reflect the versatility of cardiac MR, multislice CT, rubidium-82 PET/CT, and stress echocardiography for shedding diagnostic light on various aspects of coronary artery disease and other cardiac conditions.

Over the last several years, imagers and patients have witnessed passionate debate, sometimes even legal action, involving breast MR imaging. Dissent has finally given way to consensus over a few key points: Breast MRI is meant to complement, not replace, mammography or sonography, and it's a handy tool to guide biopsies, assess disease before surgery, and evaluate treatment response.

European legislation aimed at protecting workers from harmful effects of electromagnetic radiation, such as that emitted by mobile phones and electrical power lines, could unwittingly change the course of MR imaging if efforts to amend the law fail, according to Prof. Gabriel Krestin, who spoke in March at a press conference at the European Congress of Radiology.

A multicenter prospective trial involving 1210 patients in Europe has found that the odds of a favorable clinical outcome were one-third higher for acute stroke patients who received diffusion/perfusion MRI to determine the appropriateness of tPA thrombolysis than for patients assessed with conventional noncontrast CT.