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Vasa previa, a condition that affects approximately one in 2500 pregnancies, is almost always lethal. Adding vasa previa screening to current obstetrical ultrasound protocols could prevent mortality, according to an international group of researchers from Israel, the U.K., and the U.S. Their study was presented at the American Institute of Ultrasound in Medicine meeting in June.

Prenatal ultrasound averts fetal vasa previa deaths

Fetal MR predicts lung insufficiency in newborns

Faster MR scans are overcoming the weaknesses of past efforts to use this modality for fetal imaging. Advances in speed and resolution are apparent in mapping the fetal brain.

Fast scans boost viability of MR fetography

Cedara Software of Toronto has come up with a package that quickly renders 3D fetal views. The software is designed to allow sonographers to view 3D renderings as part of their usual workflow routine through the use of image acquisition and rendering

3D fetal software takes off

While three-dimensional ultrasound is not yet as fast as two-dimensionalimaging, reconstructed 3-D images may provide diagnostic informationthat standard scanning techniques cannot provide, according toRalph Ranalli, product manager for Philips

Fetal curvature projected in 3-D

Reportedly the only point-of-care ultrasound system that can estimate liver stiffness and attenuation that correlate to MRI-PDFF, Velacur One also may facilitate higher reimbursement than non-imaging elastography.

FDA Clears AI-Guided Point-of-Care Ultrasound for Liver Diseases

Could the NeedleVue LC1 Ultrasound System reinvent real-time ultrasound-assisted needle guidance for interventional procedures? 

FDA Clears Emerging Ultrasound Device for Interventional Procedures

Researchers noted a 78 percent malignancy rate when associated architectural distortion was present on digital breast tomosynthesis (DBT) with highly suspicious masses or microcalcifications.

Digital Breast Tomosynthesis Study Assesses Impact of Architectural Distortion on Malignancy Rates

In addition to facilitating centralized scanning for a variety of imaging, the TechLive system may help ease the strain of technologist shortages and broaden access to advanced imaging exams.

FDA Clears Remote Scanning Platform TechLive for MRI, CT, PET/CT and Ultrasound

Mammography detected 82 percent of pregnancy-associated breast cancer in a cohort of women with a high prevalence of extremely dense breasts, according to a new study.

New Study Examines Impact of Mammography in Detecting Pregnancy-Associated Breast Cancer

While Marfan syndrome is a clinical diagnosis, Alan C. Braverman, M.D., FACC, noted in a recent interview that radiologists play an “invaluable” role in facilitating early diagnosis of this genetic aortic condition.

“They can be the first to put the words into a clinician's mind that this condition that they're seeing on imaging could be something much more,” emphasized Dr. Braverman, the director of the Marfan Syndrome and Aortopathy Center at the Washington University School of Medicine in St. Louis, Mo.

“When there are combinations of findings — root aneurysm, tortuous arteries, mitral valve prolapse — when these features are seen on an imaging study, not just reporting them in diameters accurately, but also suggesting the possibility of something more, like Marfan syndrome or some genetic aortic condition when unexplained in a young person, in particular, can be so helpful to the clinician. It's invaluable.”

For patients with Marfan syndrome, Dr. Braverman emphasized complete assessment of the proximal aorta. Noting that an enlarged aortic root is common in this patient population, Dr. Braverman said the diameter of the aortic root generally exceeds 40 millimeters in younger male patients and 37 millimeters in younger female patients.

While these findings can be visualized very well on echocardiogram, cross-sectional imaging with computed tomography angiography (CTA) or magnetic resonance angiography (MRA) are recommended for initial diagnosis in adult patients and can aid in differentiating between Marfan syndrome and other conditions, such as Loeys-Dietz syndrome, noted Dr. Braverman, a professor of medicine and alumni endowed professor of cardiovascular diseases at the University of Washington School of Medicine.

(Editor’s note: For related content, see “

Improving Adherence to Best Practices for Incidental Abdominal Aortic Aneurysms on CT and MRI

Emerging ECG-Based AI Screening Software for Aortic Valve Stenosis Gets FDA’s Breakthrough Device Designation

Cardiac Ultrasound Update: FDA Clears Software with 45 Automated Parameters for Echocardiographic Analysis

For more insights from Dr. Braverman, watch the video below.

Alan Braverman, MD, discusses the role of radiologists in facilitating the timely diagnosis of Marfan syndrome.

Pertinent Insights into the Imaging of Patients with Marfan Syndrome

Emphasizing the role of radiologists in facilitating timely diagnosis of Marfan syndrome, Alan Braverman, M.D. discussed the use of echocardiography, CT, and MRI in evaluating patients with this genetic aortic condition.

While the final rule for the Mammography Quality Standards Act (MQSA) with respect to a national standard for breast density notification on mammography reports was issued in March 2023, implementation has been a significant undertaking.

“For states that did not have a breast density law before, I think this is a very heavy lift,” noted Stamatia Destounis, M.D., FACR, FSBI, FAIUM, a breast imaging specialist with Elizabeth Wende Breast Care in Rochester, N.Y., and chair of the American College of Radiology (ACR) Breast Imaging Commission.

Noting that breast density notification has been the law since January 2013 in New York, Dr. Destounis emphasized the importance of ongoing education for staff, patients and referring physicians. She recalled it taking about three to four years before physicians started asking questions about breast density.

In anticipation of the nationwide standard for breast density notification going into effect on September 10, 2024, Dr. Destounis said her facility revamped their website and emphasized social media to spread the word to patients. Accordingly, she has seen an “uptick of calls and appointments” for patients seeking genetic counseling at her facility, which has led to increased supplemental breast MRI screening.

“Many go ahead and schedule their supplemental screening with their mammogram,” added Dr. Destounis.

In order to accommodate the increased imaging volume. Dr. Destounis said her facility has hired more staff, expanded hours during the week and added weekend hours as well.

While the ongoing educational, logistical, and staffing challenges can be onerous, Dr. Destounis emphasized that every week, she is seeing cases of small invasive breast cancers on ultrasound and linear ductal enhancement on breast MRI that cannot be found on standard mammography.

Current Insights on National Breast Density Notification for Mammography Reports

Looking at Next Steps to Reinforce National Breast Density Notification

Long-Term Study Shows Merits of Contrast-Enhanced Mammography for Women with Higher Breast Cancer Risk

For more insights from Dr. Destounis, watch the video below.

In a recent interview, Stamatia Destounis, MD, discussed the impact of national breast density notification for mammography reports.

Addressing the Early Impact of National Breast Density Notification for Mammography Reports

In a recent interview, Stamatia Destounis, M.D., discussed the impact of national breast density notification for mammography reports and key considerations with staffing and ongoing education for patients, staff and referring providers on the merits of supplemental breast imaging.

Stacy Smith-Foley, M.D., was pleased to see the United States Preventive Services Task Force (USPSTF) realign with the American College of Radiology (ACR) and the Society of Breast Imaging (SBI) in recommending mammography screening to begin at 40 years of age for women of average risk for breast cancer.

However, in a recent interview, Dr. Smith-Foley expressed disappointment with the 

USPSTF’s lack of support for supplemental imaging in women with dense breasts and continued mammography screening for women 75 and older

, as well as the emphasis on biennial mammography screening for women 40 to 74 years of age.

Yearly mammography screening gives women the best chance for early breast cancer detection, emphasized Dr. Smith-Foley, the medical director of the Breast Center at the Central Arkansas Radiation Therapy Institute (CARTI) in Little Rock, Arkansas.

“When women skip their mammogram intentionally or unintentionally, … we tend to find more advanced disease. The breast cancer is larger, it is more extensive, it is more often a higher grade and more frequently involves the axilla with local regional metastasis. What I see in clinical practice is that when we have these gaps or delays (with mammography screening), the disease is more extensive,” explained Dr. Smith-Foley.

Biennial Mammography Over Annual Mammography? USPSTF Issues Updated Breast Cancer Screening Recommendations

Mammography Study Shows Link Between Enlarged Axillary Lymph Nodes and Higher Risks for Diabetes and Cardiovascular Disease

Breast MRI and Dense Breasts: A Closer Look at Early Findings from a New Prospective Trial

Dr. Smith-Foley also disagrees with the USPSTF’s assertion of insufficient evidence to continue annual mammography screening in women 75 and older.

“I have a whole collection of patients under my care in their 80s and 90s who presented to me with locally advanced breast cancer that would have been detected at an earlier stage if they had been participating in yearly screens,” maintained Dr. Smith-Foley.

For more insights from Dr. Smith-Foley, watch the video below.

Stacy Smith-Foley, MD discusses shortcomings with the recently updated USPSTF breast cancer screening recommendations.

Where the USPSTF Breast Cancer Screening Recommendations Fall Short: An Interview with Stacy Smith-Foley, MD

In a recent interview, Stacy Smith-Foley, M.D., shared her perspective on the shortcomings of the recently issued breast cancer screening recommendations from the United States Preventive Services Task Force (USPSTF).

Eric Secemsky, M.D. says there can be a fair amount of assumptions and guesswork with sole reliance on angiography to inform peripheral vascular interventions.

For example, an angiogram provides “a very poor understanding” of a significant amount of pathology that occurs on the luminal surface of the vessel, noted Dr. Secemsky in a recent interview. He maintained that intravascular ultrasound can provide greater clarity on this pathology as well as lesion severity and morphology, vessel measurements and where disease segments begin and end.

“These are just a few of the many areas where intravascular imaging catheters can really help augment and support angiography,” noted Dr. Secemsky, the director of vascular intervention and section head of interventional cardiology and vascular research with the Smith Center for Outcomes Research in Cardiology at the Beth Israel Deaconess Medical Center in Boston.

To that end, Dr. Secemsky recently led a multidisciplinary roundtable discussion, comprised of interventional radiologists, interventional cardiologists, and vascular surgeons, to discuss 

emerging evidence on the use of intravascular ultrasound

 to bolster decision-making and help improve outcomes for peripheral vascular interventions in the lower extremity.

Key Takeaways from Multidisciplinary Roundtable on Intravascular Ultrasound Use for Peripheral Vascular Interventions

Intravascular Ultrasound for Lower Extremity Interventions: Seven Takeaways from New Global Consensus Recommendations

While acknowledging different practice settings and pressures to turn over rooms for procedures, Dr. Secemsky said the perception that using imaging catheters increases procedure time is a fallacy. Research in the coronary intervention space has demonstrated that increased familiarity with imaging catheters shows no increased procedure time and additional benefits such as reduced radiation time and exposure to contrast media, according to Dr. Secemsky, an assistant professor of medicine at Harvard Medical School.

For further insights from Dr. Secemsky, watch the video below.

Eric Secemsky, M.D., discusses advantages of intravascular ultrasound (IVUS) in supplementing angiography for peripheral vascular interventions.

Making the Case for Intravascular Ultrasound Use in Peripheral Vascular Interventions

In a recent interview, Eric Secemsky, M.D., discussed an array of benefits for the use of intravascular ultrasound (IVUS) in supplementing angiography for peripheral vascular interventions, current barriers preventing more widespread adoption of the technology and other salient insights from a recent multidisciplinary roundtable discussion.

Reportedly 365,000 people in the United States had breast augmentation procedures in 2021.

 Emerging research comparing digital breast tomosynthesis (DBT) use in women with and without breast implants found a 22 percent lower cancer detection rate for women with breast implants. Yet there are currently no imaging guidelines specifically geared to breast cancer screening in patients with breast implants.

Society of Breast Imaging (SBI) conference

, Stephen Rose, M.D, pointed out the breast implants may obscure between nine to 44 percent of glandular tissue on imaging. In a recent video interview, Dr. Rose said there are a number of factors, ranging from age of the implant and fibrosis to implant size, implant-related scarring and breast size, that can affect interpretation of breast imaging in patients with breast implants.

In retrospective research presented at the SBI conference, Dr. Rose and colleagues reviewed data from 350,845 DBT exams (including 20,929 DBT exams for women with breast implants) performed at 49 community-based outpatient imaging centers in 2019. In addition to the aforementioned lower cancer detection rate in women with implants, Dr. Rose and colleagues found that women with breast implants had a nearly 5.5 percent increase in ductal carcinoma in situ (DCIS) and a 4.8 percent higher incidence of positive lymph node involvement in detected cancers.

Breast Reconstruction: Current Principles and Emerging Concepts in Imaging

Study Highlights Use of Contrast-Enhanced Mammography in Women with Breast Implants

Has the time come for imaging guidelines that are more specific to the nuances and supplemental imaging needs for women with breast implants?

“Other than the same guidelines we use for women without breast implants, there really hasn’t been any specific guidelines by our societies that suggest doing more (for women with breast implants),” noted Dr. Rose, the founder and president of Rose Imaging Specialists. “It’s all been pretty anecdotal recommendations and it’s not like this is an insignificant number of patients. In some of our populations, 10 to 15 percent have implants.”

For more insights from Dr. Rose, watch the video below.

1. The Aesthetic Society. Aesthetic Plastic Surgery National Databank Statistics 2020-2021. Available at: https://cdn.theaestheticsociety.org/media/statistics/2021-TheAestheticSocietyStatistics.pdf . Accessed June 14, 2023.

In a recent video interview, Stephen Rose, M.D., reviewed a variety of factors that can impact interpretation of breast imaging for women with breast implants and discussed recent research showing a 22 percent reduction in cancer detection rate for this population in comparison to women without breast implants.

Radiology Challenges with Breast Cancer Screening in Women with Breast Implants

When evaluating an artificial intelligence (AI) model for initial assessment of left ventricular ejection fraction (LVEF) on echocardiograms, David Ouyang, M.D., said he was genuinely surprised that cardiologists had greater confidence in initial AI assessments than those provided by cardiac sonographers with an average of 14.1 years of experience.

In the randomized trial, recently published in 

, cardiologists revised 27.2 percent of initial LVEF assessments by sonographers in comparison to 16.8 percent of AI assessments.

“We initially thought of the tool as kind of a streamlining tool where it speeds things up. We actually designed the trial as a non-inferior trial. We weren’t expecting AI to be better than sonographers. Hopefully, it would be equivalent,” noted Dr. Ouyang, who is affiliated with the Department of Cardiology at the Smidt Heart Institute and the Division of Artificial Intelligence in Medicine at the Cedars-Sinai Medical Center in Los Angeles. “We were pleasantly surprised that AI actually was superior. This really speaks to the high level of precision that automation delivers.”

Study Finds AI More Effective Than Sonographer Interpretation of Cardiac Function on Echocardiograms

Can AI Improve Triage of CT Pulmonary Angiography Exams for Acute PE?

AI Platform for Ultrasound Detection of Cardiac Amyloidosis Gets FDA Breakthrough Device Designation

In a recent interview, Dr. Ouyang also discussed another 

 that employed deep learning segmentation of cardiac magnetic resonance imaging (MRI) to examine how variations in left ventricle sphericity can impact cardiovascular risks. Based on their findings from a large cohort of nearly 39,000 participants from the UK Biobank, Dr. Ouyang and colleagues found that one standard deviation increase in the left ventricle sphericity index led to a 47 percent increased risk for cardiomyopathy and a 20 percent higher risk of atrial fibrillation.

For more insights from Dr, Ouyang, watch the video below.

In a recent video interview, David Ouyang, M.D., shared insights from two recent studies he co-authored on the use of artificial intelligence (AI) to improve initial assessment of left ventricular ejection fraction (LVEF) on echocardiography and ascertain cardiac risks associated with changes in the left ventricle sphericity index seen on magnetic resonance imaging (MRI).

Emerging AI Advances in Cardiac Imaging

Recently published research suggests an emerging handheld ultrasound technique could be beneficial for breast cancer screening in underserved populations with limited or no access to conventional imaging modalities.

, assessed volume sweep imaging (VSI) of 170 palpable breast lumps with a handheld ultrasound probe (Butterfly iQ, Butterfly Network). The handheld VSI ultrasound scans were performed by medical students who received less than two hours of training on the VSI protocol and had no prior ultrasound training, according to the study.

The researchers found that the VSI handheld ultrasound technique had a 97 percent sensitivity for breast masses and an 87 percent agreement with conventional ultrasound devices on Breast Imaging-Reporting and Data System (BI-RADS) assessments.

In a recent video interview, Thomas Marini, MD, discussed the VSI technique, the study findings, and the global need for increased access to ultrasound imaging.

“The Pan-American Health Organization (PAHO) estimates that two-thirds of people in the world don’t have access to any form of medical imaging and that 70 to 80 percent of their conditions can be diagnosed with basic modalities like ultrasound and X-ray,” noted Dr. Marini, who is affiliated with the University of Rochester Medical Center.

For more insights from Dr. Marini, watch the video below.

In a recent video interview, Thomas Marini, MD discussed the need for ultrasound access to facilitate breast cancer screening in underserved populations and the potential utility of volume sweep imaging, a handheld ultrasound technique that requires minimal training and has a high rate of agreement with conventional ultrasound on BI-RADS assessments.

Can Volume Sweep Imaging with Ultrasound be a Viable Option for Breast Cancer Screening in Underserved Countries?

The purchase of new and cutting-edge imaging equipment comes with a lot of excitement—and a learning curve. That's where Canon Medical Education comes in, providing a host of education solutions for clients that include both in-person and virtual training and continuing education opportunities.

The education arm of Canon Medical Systems USA provides a customizable plan to ensure that all imaging associates are well-trained and comfortable operating advanced equipment including MR and CT, as well as vascular and cath applications, among others. 

Understanding that every learner is different, Canon offers educational opportunities that include in-person, at their Institute of Advanced Imaging in Irvine, California; on-site training at a client facility; online and instructor-led courses in their Canon Learning Center; as well as CE and non-CE webinars and special programs.

To learn more about Canon's educational offerings, 

Canon Medical Systems offer a range of in-person and virtual educational opportunities for their clients. 

Education in Radiology: Canon's Customized Approach

October and beyond, the role of breast imagers in radiology and healthcare overall extend far beyond the reading room. Breast imagers have a unique opportunity to closely interface with patients during screenings and follow-ups, offering not only encouragement but education. 

For Dana N. Bonaminio, M.D., choosing breast imaging as a focus was easy. "Breast imaging is not one of those subspecialties where you sit in a dark room and read images all day. It's very patient-centric, radiology-centric and it puts you at the front, so we're not hiding behind a screen, we're really interacting with our patients." 

Bonaminio, who is the Women's Imaging National Subspecialty Lead for Radiology Partners; Lead Breast Imager, Advanced Diagnostic Imaging; and Director of Breast Imaging at Ascension Saint Thomas Midtown Center for Breast Health in Nashville, Tennessee, uses her role to empower women to take control of their breast health. 

 to discuss what motivates her, how her practice has changed post-pandemic, and what exciting trends she's hoping to take advantage of to improve her radiology practice. 

The work of a breast imager goes far beyond the pink-out of every October.

Dana N. Bonaminio, M.D. on Priorities for Today's Breast Imagers

Welcome to Diagnostic Imaging’s Weekly Scan. I’m senior editor, Whitney Palmer.

Before we get to our featured interview this week with Dr. Katerina Dodelzon from Weill Cornell Medicine about COVID-19-vaccine related adenopathies that can mimic breast malignancies on imaging, here are the top stories of the week.

As more and more people get vaccinated for COVID-19, investigators from Weill Cornell have cautioned radiologists about a common side effect of vaccination – swollen lymph nodes. Based on their experience with four women in their institution – these adenopathies are showing up on breast imaging and can mimic breast malignancies. In fact, adenopathies can appear within two-to-four days in 11.6 percent of patients after one dose and 16 percent after two. The presentation on ultrasound and mammography has been the same for both the Moderna and Pfizer-BioNTech vaccines. In their study published in 

they recommend that radiologists consider vaccine-related adenopathy as a differential diagnosis for unilateral axillary adenopathy and ask a patient about her COVID-19 vaccine history. Doing so could reduce unnecessary node biopsies. However, you should conduct repeated targeted ultrasound within four-to-12 weeks after the second vaccine dose, and if the adenopathy is still there, conduct an ultrasound-guided core needle biopsy to rule out malignancy.

More evidence emerged this week in the debate over whether radiation exposure from CT scans can increase the likelihood of cancer. In a study published in 

investigators from South Korea looked at cancer incidence in patients who had a CT scan associated with acute appendicitis. They found that, in fact, the number of hematologic malignant neoplasms does increase with the number of CT scans performed, particularly in children under age 16. This can be problematic, they said, because appendicitis is common in children, and CT is increasing being used with the condition. By examining patient records from 825,820 individuals, they identified an incidence ratio rate of 1.26 for hematologic malignant neoplasm with the uptick beginning roughly 3 years post-CT exposure. The excess incidence ratio rate for all neoplasms reached 4.44, but in the CT group, specifically, it was 1.40 for leukemia. And, for patients under 16, it was 1.21 after one CT and 1.60 after two or more. The results, they said, underscored the need to abide by the Image Gently and Image Wisely guidelines.

For more coverage based on industry expert insights and research, subscribe to the Diagnostic Imaging e-Newsletter 

For prostate cancer, one of the most critical steps is being able to accurately identify which men will suffer a recurrence. According to a group from Case Western Reserve University, achieving that goal could get much easier thanks to their artificial intelligence tool, 

. They applied RadClip to pre-operative MRI scans from 200 patients who had undergone radical prostatectomy and found it can identify small heterogeneity and texture pattern differences both inside and outside the tumor. With that information, the team said, it is easier to estimate and predict post-surgical outcomes. Based on their findings, RadClip outperforms existing predictive strategies, such as Cancer of the Prostate Risk Assessment and the genomic-based Decipher® Prostate Cancer Test.

And, finally, this week, as mentioned earlier, anecdotal reports were published this week about COVID-19 vaccine-related adenopathies that can mimic malignant breast abnormalities. For the details of the study, 

 spoke with Dr. Katerina Dodelzon, assistant professor of radiology at Weill Cornell Medicine. Dodelzon, who is also a board-certified breast imager, discussed the findings of her team’s experience with the four women included in the study and what it means for radiologists, both in breast imaging and other sub-specialties. Here’s what she had to say.

COVID-19 Vaccine Adenopathies Mimic Breast Malignancies; Appendicitis, CT Exposure and Increased Cancer Risk; and MRI AI Tool for Prostate Cancer Recurrence Prediction

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