June 4, 2008 CT-detected incidental adrenal masses prove to be mostly benign H. A. Abella -------------------------------------------------------------------------------- A study of nearly 1000 patients with incidental adrenal tumors detected during abdominal CT scans has found that these lesions are almost always benign, according to Brown University researchers. The clinical literature notes that incidental lesions of the adrenal gland appear in about 5% of all CT exams performed. Researchers…
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June 4, 2008 Diagnostic Imaging. Benefits of abdominal CT in the ER outweigh risks -------------------------------------------------------------------------------- A prospective, ongoing study from Harvard University shows that CT's benefits may outweigh the risks of overutilization, at least for triaging abdominal pain. Radiologist Dr. Rathachai Kaewlai and colleagues at Massachusetts General Hospital asked ER physicians questions about the top diagnosis, their level of confidence regarding…
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June 3, 2008 Diagnostic Imaging. Role gadolinium plays in NSF incidence remains unclear Evidence of effects of macrocyclic versus linear chelates and free versus bound elements lacks strength to provide proof of connection -------------------------------------------------------------------------------- The controversial topic of nephrogenic systemic fibrosis featured prominently in this year's European Congress of Radiology program. This scleroderma-like disorder has been linked to the…
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June 3, 2008 Diagnostic Imaging. PIB-PET offers early proof of Alzheimer's disease onset -------------------------------------------------------------------------------- Groundbreaking research has confirmed that Pittsburgh Compound B binds to the beta-amyloid deposits in the brains of patients with Alzheimer's disease. The finding is a major step toward an early, definitive diagnosis of the memory-stealing condition. "As excited as researchers get, we are pretty excited," said senior author…
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June 3, 2008 Diagnostic Imaging. PET tops CT for malignant lung nodule characterization -------------------------------------------------------------------------------- A large multicenter trial rates FDG-PET as more reliable than CT for the detection of malignant solitary pulmonary nodules. Findings suggest, however, that a combined, rather than single, modality approach may lead to earlier treatment and help avoid invasive procedures. From January 1999 to June 2001, lead investigator Dr.…
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June 3, 2008 Diagnostic Imaging. Obesity impairs accuracy of obstetric sonography -------------------------------------------------------------------------------- Pregnant women who are overweight or obese are at least 10 times more likely than women of normal weight to have their fetal ultrasound screening recalled due to poor results, according to Canadian researchers. Dr. Phyllis Glanc and colleagues at the University of Toronto assessed 100 women with a body mass index >30 who underwent…
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June 3, 2008 Diagnostic Imaging. NSF discovery process may expose lax record-keeping -------------------------------------------------------------------------------- A casual attitude toward keeping track of gadolinium-enhanced studies may come back to haunt radiology departments that become involved in several federal lawsuits alleging a connection between cases of nephrogenic systemic fibrosis and gadolinium-based MR contrast agents. In a 2007 study that examined allergic reactions to…
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June 3, 2008 Diagnostic Imaging. Myocardial perfusion CT closes in on cardiac fMRI MRI still generates better contrast and less noise than perfusion CT on delayed enhancement images -------------------------------------------------------------------------------- With piles of accumulated evidence demonstrating the ability of multislice CT to diagnose coronary artery disease, researchers are expanding clinical application of the modality to the measurement of myocardial viability following…
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June 3, 2008 Diagnostic Imaging. MRS links fibromyalgia pain to changes in brain molecule -------------------------------------------------------------------------------- A new study from the University of Michigan featuring proton MR spectroscopy has found a key linkage between the widespread muscle pain, tenderness, and fatigue associated with fibromyalgia and brain glutamate. Findings could lead to new drugs to treat the condition, researchers said. Dr. Daniel J. Clauw, director of the UM…
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June 3, 2008 Diagnostic Imaging. Isotope supply crash drives push for new moly sources Political bickering, engineering incompetence, and benign neglect make a mess of North American medical isotope supply system James Brice -------------------------------------------------------------------------------- Knowledgeable Canadians considered the molybdenum-99 crisis of 2007 a national disgrace. A squabble between the Canadian Nuclear Safety Commission and Atomic Energy Canada, the federal…
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June 3, 2008 Diagnostic Imaging. IRs look for silver lining as government pushes quality Specialty fights falling reimbursement while persuing practice improvements via reporting and drug and device initiatives H. A. Abella -------------------------------------------------------------------------------- Interventional radiologists, like their diagnostic counterparts, remain under pressure as payers ratchet back reimbursements. But they continue to fight on the reimbursement front and see some…
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June 3, 2008 Diagnostic Imaging. Investment in imaging exploits trends in genetics, nanotech James Brice -------------------------------------------------------------------------------- Necessity is not always the mother of invention. If you are Dr. Roderic Pettigrew, director of the National Institute of Biomedical Imaging and Bioengineering, invention can germinate from any number of sources. The likelihood of its ultimate adoption increases with the help of federal funds and the guidance…
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June 3, 2008 Diagnostic Imaging. GE's Signa MR750 brings new power, simplicity to 3T -------------------------------------------------------------------------------- Advanced gradients and parallel imaging, along with ergonomic features, combine to boost productivity A new 3T scanner unveiled last month by GE Healthcare delivers unprecedented speed and resolution in some of the toughest areas of the body to image. Combining advanced parallel imaging software with powerful gradients and an…
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June 3, 2008 Diagnostic Imaging. Fear of nuclear terrorism lurks behind molybdenum supply debate John C. Hayes -------------------------------------------------------------------------------- The crash of the radioisotope supply last winter gets a close look in this month's cover story. It details the politics and policy issues that closed down the Chalk River reactor in Ontario for nearly a month, leaving North American nuclear medicine physicians without a reliable supply of technetium-99.…
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June 3, 2008 Diagnostic Imaging. Fast CT scans increase risk of contrast timing errors -------------------------------------------------------------------------------- The potential advantages of multislice CT for contrast-enhanced imaging are clear. The improved spatial and temporal resolution offered by MSCT means that high-quality images can be obtained far more quickly. Phases of enhancement are well defined, the volume of contrast required for vessel imaging can be reduced, and, depending…
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June 3, 2008 Diagnostic Imaging. Drug-resistant TB story illustrates global challenge for radiology John C. Hayes -------------------------------------------------------------------------------- Ours is a global economy, and personal mobility is part of the equation. Immigration rates are up everywhere, and with this movement come new trends and developments in disease that strain the healthcare system, including imaging. Part of this is evident in an Overread article in this issue ("Chest…
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June 3, 2008 Contrast-enhanced ultrasound diagnoses small renal lesions Wendy Despain -------------------------------------------------------------------------------- Solid renal parenchymal lesions with a diameter of 5 cm or less can be difficult to diagnose, requiring irradiation and biopsy. Catching renal cell carcinoma in early stages before tumors grow larger than 7 cm, however, increases a patient's chances of survival over five years. Researchers in China have found that…
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June 3, 2008 Diagnostic Imaging. Chest x-ray remains crucial for finding drug-resistant TB -------------------------------------------------------------------------------- Budget cuts have been added to coinfection with human immunodeficiency virus and multidrug-resistant disease as the biggest threats to the prevention of tuberculosis in the U.S. San Francisco and neighboring Bay Area communities saw TB incidence decline until 2006, thanks to a stringent control program funded by the Centers…
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June 3, 2008 Diagnostic Imaging. Case of the Month -------------------------------------------------------------------------------- CLINICAL HISTORY A 40-year-old man presented with upper and lower back pain. His symptoms worsened over the course of a month. The patient denied any bowel or bladder dysfunction, radiating symptoms, or motor deficits. FINDINGS Axial T2-weighted MR images (Figures 1 and 2) reveal a longitudinally split thoracic spinal cord with cerebrospinal fluid intervening…
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June 3, 2008 Diagnostic Imaging. Breast MRI CAD zeroes in on malignant lesions -------------------------------------------------------------------------------- Results from two recent studies suggest computer-aided detection for breast MRI may be closing in on true cancer detection. Researchers from Penn Diagnostics, a breast MRI CAD company, and George Washington University tested the ONCAD system for contrast-enhanced MRI. They reviewed images of 102 biopsy-proven breast cancers and 131…
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