Medical Imaging
28 Nov Virtual Reality Systems Can Generate Immersive 3D Images of Fetuses
[caption id="attachment_30002" align="alignleft" width="200"]
Close-up of fetus at 26 weeks[/caption]
MedicalResearch.com Interview with:
Dr. Heron Werner Junior
Clínica de Diagnóstico por Imagem – CDPI
Rio de Janeiro - Brazil
MedicalResearch.com: What is the background for this study?
Response: A growing number of technological advancements in obtaining and viewing images through noninvasive techniques have brought major breakthroughs in fetal medicine.
In general, two main technologies are used to obtain images within the uterus during pregnancy i.e. ultrasound (US) and magnetic resonance imaging (MRI).
16 Nov Coronary Artery Calcium Found in 1/3 Women Designated “Low-Risk’
MedicalResearch.com Interview with: [caption id="attachment_29717" align="alignleft" width="180"]
Dr. Maryam Kavousi[/caption]
Maryam Kavousi MD, PhD, FESC
Assistant Professor
Department of Epidemiology
Erasmus University Medical Center
Rotterdam The Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The most recent American College of Cardiology/American Heart Association (ACC/AHA) cardiovascular disease (CVD) prevention guidelines recommend statins for a larger proportion of populations.
Notably, a large group of women are categorized as low CVD risk by the guidelines and would therefore not typically qualify for intensive management of their standard risk factors. Coronary artery calcium (CAC) scanning allows for the detection of subclinical coronary atherosclerosis and is viewed as the vessel’s memory of lifetime exposure to risk factors. We therefore aimed to address the utility of CAC as a potential tool for refining CVD risk assessment in asymptomatic women at low CVD risk based on the new guidelines.
This study involved data on 6,739 low-risk women from 5 population-based cohort studies across the United States and Europe. We found that CAC was present in 36% of low-risk women and was associated with increased risk of CVD.
08 Nov Brain Gray Matter Volume Predictive of Weight Loss Success
MedicalResearch.com Interview with: Fatemeh Mokhtari Medical Imaging PhD Student VT-WFU SBES MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of this study was to use baseline anatomical brain MRI scans to prospectively predict weight loss success following an intensive lifestyle intervention. In the study, 52 participants, age 60 to 79, were recruited from the Cooperative Lifestyle Interventions Programs II (CLIP-II) project. The participants were overweight or obese (BMI greater than 28 and less than 42) and had a history of either cardiovascular disease or metabolic syndrome. All participants had a baseline MRI scan, and then were randomized to one of three groups – diet only, diet plus aerobic exercise training or diet plus resistance exercise training. The goal of the 18-month diet and exercise program was a weight loss of 7 to 10 percent of body mass. Basic brain structure information garnered from the MRIs was classified using a support vector machine, a type of computerized predictive algorithm. Specifically, we trained a computational predictive model which mapped each subject’s brain scan to weight loss performance. Predictions were based on baseline brain gray and white matter volume from the participants’ MRIs and compared to the study participants’ actual weight loss after the 18 months. The accuracy of the model was then tested, and our prediction algorithms were 78% accurate in predicting successful weight loss. Brain gray matter volume provided higher prediction accuracy compared with white matter and the combination of the two outperformed either one alone.06 Nov Six Sigma Lean Models Applicable To Emergency Room Care
MedicalResearch.com Interview with: [caption id="attachment_29428" align="alignleft" width="143"]
Dr. Devon A. Klein[/caption]
Devon A. Klein, MD, MPH
Asst. Professor of Radiology and Orthopaedics
Hofstra Northwell School of Medicine
Associate Chairman, Radiology
Lenox Hill Hospital
New York, NY 10075
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As our Emergency Department continued to grow our Radiology Department was challenged to accommodate the resultant increased volume with fixed resources (i.e. CT Scanners) and maintain CT scan throughput. Uncoordinated insular efforts within the Department of Radiology failed to resolve the problem. A collaborative approach utilizing Six Sigma lean and involving stakeholders from the Departments of Radiology, Emergency, Medicine, and Patient Transportation was able to better illustrate the “bottlenecks” and devise solutions.
29 Oct ECG and Echocardiography for Identification of Arrhythmic Events in Early ARVC
MedicalResearch.com Interview with: Kristina H. Haugaa, MD, PhD, FESC Ida Skrinde Leren MD, PhD Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet Oslo, Norway MedicalResearch.com: What is the background for this study? Response: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inheritable cardiomyopathy, predisposing to life-threatening arrhythmias. Ventricular arrhythmias are frequent in ARVC patients and importantly, arrhythmias may occur also before evident structural changes are seen, making risk stratification challenging. Additional tools are needed to detect early disease and to optimize medication and timing of implantation of a cardioverter defibrillator (ICD). We aimed to explore early markers of ARVC disease and their association with previous ventricular arrhythmias.27 Oct Cardiac CT Reduces Need for Catheterization in Atypical Chest Pain
MedicalResearch.com Interview with: [caption id="attachment_29195" align="alignleft" width="193"]
Prof. Marc Dewey[/caption]
Professor Marc Dewey
Heisenberg professor of radiology
Vice Chairman of the Department of Radiology at Charité (Campus Mitte)
Berlin Germany
MedicalResearch.com: What is the background for this study?
Response: Over 3.5 million cardiac catheterisations are performed in Europe each year. This study, jointly conducted by radiologists and cardiologists at Charité – Universitätsmedizin Berlin and published in today’s issue of The BMJ, compares computed tomography (CT) with cardiac catheterisation in patients with atypical chest pain and suspected coronary artery disease (CAD).
MedicalResearch.com: What are the main findings?
Response: CT reduced the need for cardiac catheterisation from 100% to 14% in the group of patients who received CT first instead of catheterisation. If catheterisation was needed in the CT group, the proportion of catheterisations showing obstructive CAD was 5 times higher than in the catheterisation group. Over a period of 3.3 years, the patients in the CT group neither had more cardiac catheterisations nor an increase in cardiovascular events. Moreover, CT shortened the length of stay by 23 hours and 79% of patients said they would prefer CT for future examinations of the heart. Overall, the results of the BMJ study show that CT is a gentle test for reliably ruling out CAD in patients with atypical chest pain who are currently being referred for cardiac catheterisation in routine clinical practice.
23 Sep Medicare Shared Savings Program May Reduce Hospitals’ Propensity To Purchase New CT Machines
MedicalResearch.com Interview with: Hui Zhang, Ph.D., MBA Virginia Polytechnic Institute and State University Blacksburg MedicalResearch.com: What is the background for this study? What are the main findings? Response: To promote healthcare coordination and contain the rising costs in the US healthcare system, a variety of payment innovations has been developed and field-tested in both public and private sector. Among them, the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs), administered by the Centers for Medicare and Medicaid Services (CMS) has received considerable attention. Our study took a mathematical modeling approach and comprehensively captured and analyzed the effect of this new payment systems on healthcare stakeholder decisions and system-wide outcomes. Our results provided decision-making insights for payers on how to improve MSSP, for ACOs on how to distribute MSSP incentives among their members, and for hospitals on whether to invest in new CT imaging systems.19 Sep Computer Bests Neuroradiologists in Distinguishing Tumor Recurrence From Radiation Necrosis
Posted at 21:39h
in Author Interviews, Brain Cancer - Brain Tumors, Case Western, MRI, Radiology, Technology
MedicalResearch.com Interview with:
[caption id="attachment_28107" align="alignleft" width="200"]
Dr. Pallavi Tiwari[/caption]
Dr. Pallavi Tiwari PhD
Assistant Professor biomedical engineering
Case Western Reserve University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: One of the biggest challenges in neuro-oncology currently is distinguishing radionecrosis, a side-effect of aggressive radiation, from tumor recurrence on imaging. Surgical intervention is the only means of definitive diagnosis, but suffers from considerable morbidity and mortality. The treatments for radionecrosis and cancer recurrence are very different. Early identification of the two conditions can help speed prognosis, therapy, and improve patient outcomes.
The purpose of this feasibility study was to evaluate the role of machine learning algorithms along with computer extracted texture features, also known as radiomic features, in distinguishing radionecrosis and tumor recurrence on routine MRI scans (T1w, T2w, FLAIR). The radiomic algorithms were trained on 43 studies from our local collaborating institution - University Hospitals Case Medical Center, and tested on 15 studies at a collaborating institution, University of Texas Southwest Medical Center. We further compared the performance of the radiomic techniques with two expert readers.
Our results demonstrated that radiomic features can identify subtle differences in quantitative measurements of tumor heterogeneity on routine MRIs, that are not visually appreciable to human readers. Of the 15 test studies, the radiomics algorithm could identify 12 of 15 correctly, while expert 1 could identify 7 of 15, and expert 2, 8 of 15.
15 Sep Brain Scans Can Predict Specific Spontaneous Emotions
Posted at 01:27h
in Author Interviews, Duke, Medical Imaging, MRI, PLoS, Psychological Science, Social Issues
MedicalResearch.com Interview with:
[caption id="attachment_27929" align="alignleft" width="133"]
Dr. Kevin LaBar[/caption]
Kevin S. LaBar, Ph.D.
Professor and Head, Cognition & Cognitive Neuroscience Program
Co-Director of Undergraduate Studies in Neuroscience
Center for Cognitive Neuroscience
Duke University
Durham, NC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Emotion research is limited by a lack of objective markers of emotional states. Most human research relies on self-report, but individuals may not have good insight into their own emotions. We have developed a new way to identify emotional states using brain imaging and machine learning tools. First, we induced emotional states using film and music clips while individuals were in an MRI scanner. We trained a computer algorithm to identify the brain areas that distinguished 7 emotions from each other (fear, anger, surprise, sadness, amusement, contentment, and a neutral state). This procedure created a brain map for each of the 7 emotions. Then, a new group of participants self-reported their emotional state every 30 seconds in an MRI scanner while no stimuli were presented. We could predict which emotion was spontaneously reported by the subjects by comparing their brain scans to each of the 7 emotion maps. Finally, in a large group of 499 subjects, we found that the presence of the fear map during rest predicted state and trait anxiety while the presence of the sadness map predicted state and trait depression.
15 Sep MRI Not Always Better Than Regular X Rays For Knee Pain Evaluation
MedicalResearch.com Interview with: [caption id="attachment_27918" align="alignleft" width="155"]
Dr. Muyibat Adelani[/caption]
Muyibat Adelani, MD
Assistant Professor of Orthopaedic Surgery
Washington University
St. Louis
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In our practice, we noticed that more patients are coming in already having had MRIs. We wanted to know how many people actually had weight-bearing knee x-rays before the MRI. We found that only a quarter of patients had weight-bearing x-rays before the MRI. We found that half of the MRIs obtained prior to referral to an orthopaedic surgeon did not contribute to the patient's treatment.
08 Sep MRI Generally Safe For Fetus in First Trimester, But Gadolinium Should Be Avoided Unless Strongly Indicated
MedicalResearch.com Interview with: Dr. Joel G. Ray MD, MS, FRCPC Professor, Department of Medicine, University of Toronto Professor Department of Obstetrics and Gynecology St. Michael’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have little information about the fetal safety to of MRI in the first trimester of pregnancy, or that of MRI with gadolinium contrast performed at any point in pregnancy.31 Aug How Can Radiologists Detect Cancer In a Fraction of a Second?
MedicalResearch.com Interview with: [caption id="attachment_27548" align="alignleft" width="125"]
Dr. Karla Evans[/caption]
Karla K. Evans, Ph.D.
Lecturer, Department of Psychology
The University of York
Heslington, York UK
MedicalResearch.com: What is the background for this study?
Response: This research started after initially talking to radiologists and pathologists about how they search a radiograph or micrograph for abnormalities. They talked about being able to tell at the first glance if the image had something bad about it. Jokingly, they talked about “having the force” to see the bad. We wanted to know whether this hunch after the brief initial viewing was real and to systematically test it. We collected radiographic and micrographic images, half of them that had signs of cancer in them and half of them that didn't, and we briefly presented them (250 millisecond to 2000 milliseconds) to radiologists or pathologistsrespectively. They simply had to report whether they would recall the patient or not and try localize on the outline the location of the abnormality. We first reported these finding in the following paper.
Evans et al. (2013) The Gist of the Abnormal: Above chance medical decision making in the blink of an eye. Psychonomic Bulletin & Review (DOI) 10.3758/s13423-013-0459-3
In addition to finding that radiologists and pathologists can indeed detect subtle cancers in a quarter of a second we also found that they did not know where it was in the image leading us to conclude that the signal that they were picking up must be a global signal (i.e. the global image statistic or the texture of the breast as a whole) rather than the result of a local saliency. This led me to start further exploring this signal in order to characterize it when I moved to University or York, UK to establish my own lab.
25 Aug Technetium Cardiac Imaging Predicts Prognosis of Cardiac Amyloidosis
MedicalResearch.com Interview with: [caption id="attachment_27269" align="alignleft" width="100"]
Dr. Adam Castano[/caption]
Adam Castano, M.D., M.S.
Division of Cardiology
Columbia University Medical Center
New York Presbyterian Hospital
MedicalResearch.com: What is the background for this study?
Response: Transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized cause of heart failure with preserved ejection fraction (HFpEF). Traditionally, the gold standard for diagnosis has required an endomyocardial biopsy coupled with either immunohistochemistry or mass spectroscopy. These specialized tests are only performed at centers with experienced satff, do not yield prognostically useful information, may be inadvisable for frail older adults, and often present logistical challenges that lead to delayed care.
Fortunately, single center studies have demonstrated excellent diagnostic accuracy using technetium 99m pyrophosphate (Tc99mPYP) cardiac imaging for noninvasively detecting ATTR-CA and differentiating it from another major type of cardiac amyloidosis called light chain (AL). But the diagnostic accuracy of this technique in a multicenter study and the association of Tc99mPYP myocardial uptake with survival were not known prior to this study.
Therefore, we assessed in a multicenter study Tc99mPYP cardiac imaging as a diagnostic tool and its association with survival. We conducted a retrospective cohort study of 229 patients evaluated at 3 academic specialty centers for cardiac amyloidosis and also underwent Tc99mPYP cardiac imaging. We measured retention of Tc99mPYP in the heart using a semiquantitative visual score (range 0-3) and a more quantitative heart-to-contralateral (H/CL) ratio calculated as total counts in a region of interest over the heart divided by background counts in an identical size region of interest over the contralateral chest. The outcome measured was time to death after Tc99mPYP imaging.
24 Aug Patients With Psoriasis Have Coronary Calcium Scores Comparable to Diabetes
Posted at 21:00h
in Author Interviews, Dermatology, Diabetes, Heart Disease, JAMA, Medical Imaging, NIH
MedicalResearch.com Interview with:
Nehal N. Mehta, .MD., M.S.C.E. F.A.H.A.
Lasker Clinical Research Scholar
Section of Inflammation and Cardiometabolic Diseases
NIH
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Psoriasis is associated with accelerated cardiovascular (CV) disease; however, screening for CV risk factors in psoriasis remains low. Coronary artery calcium (CAC) score estimates the total burden of atherosclerosis. Psoriasis has been associated with increase CAC score, but how this compares to patients with diabetes, who are aggressively screened for CV risk factors, is unknown.
19 Aug Lung Cancers Detected On Screening CT Scans Have Better Survival
MedicalResearch.com Interview with: [caption id="attachment_27200" align="alignleft" width="150"]
Dr. Matthew Schabath[/caption]
Matthew B. Schabath PhD
Department of Cancer Epidemiology
H. Lee Moffitt Cancer Center and Research Institute
Tampa, Florida
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our study is a post-hoc analysis of data from a large randomized clinical trial (RCT) called the National Lung Screening Trial (NLST). The NLST found that lung cancer screening with low-dose helical computed tomography (LDCT) significantly reduced lung cancer deaths by 20 percent compared to screening with standard chest radiography (i.e., X-Ray).
In our publication, we performed a very detailed analysis comparing outcomes of lung cancer patients screened by LDCT according to their initial (i.e., baseline), 12 month, and 24 month screening results. We found that patients who had a negative baseline screening but tested positive for lung cancer at the 12- or 24-month screen had lower survival and higher mortality rates than patients who had a positive initial screen that was a non-cancerous abnormality but developed lung cancer in subsequent screens.
02 Aug Risk of Background Changes on Breast MRI Reexamined
MedicalResearch.com Interview with: [caption id="attachment_26671" align="alignleft" width="75"]
Dr. Bennani-Baiti[/caption]
Barbara Bennani-Baiti, MD, MS and
[caption id="attachment_26672" align="alignleft" width="69"]
Dr. P. Baltzer[/caption]
Pascal Andreas Baltzer MD
Departement of Biomedical Imaging and Nuclear Medicine
Medical University of Vienna
Vienna, Austria
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Breast MRI ist the most sensitive method for detecting breast cancer. It is currently routinely used in the screening of high-risk patients and as an additional imaging technique in case of inconclusive conventional imaging (mammography and ultrasound).
Besides its high sensitivity for detection of breast cancer, breast MRI further provides functional information about normal breast tissue perfusion. Background parenchymal enhancement (BPE) reflects the perfusion or vascularization of the breast and is generally higher in active breast tissue. High-risk patients harbor breast tissue that is at an elevated risk for breast cancer due to several factors (i.e. mutations such as BRCA1, high familial risk, previous radiation of the chest wall, etc.). After a connection between increased breast cancer odds and elevated BPE has been shown in high-risk patients, the community has since assumed that an elevated background enhancement at breast MRI equates an elevated risk for breast cancer for all women. We have shown that this not true for women that are not considered high-risk. In fact, the only risk factor for women undergoing breast MRI without additional risk factors is age.
29 Jul PET Scan Identifies Low Serotonin Functioning Linked To Suicidal Behavior
Posted at 22:04h
in Author Interviews, Depression, Medical Imaging, Mental Health Research, Radiology
[caption id="attachment_26646" align="alignleft" width="200"]
Dr. Maria Oquendo[/caption]
MedicalResearch.com Interview with:
Maria A. Oquendo, M.D.
Professor of Psychiatry
Vice Chair for Education
Columbia University Medical Center
American Psychiatric Association, President
International Academy of Suicide Research, President
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our team has worked for years on identifying the biological underpinnings of both risk for suicidal behavior (SB) and for predicting the lethality or medical consequences of suicidal behavior. We have shown that if you compare those who are depressed and have had SB to those who are depressed but do not have suicidal behavior, you can see clear differences in the serotonin system using Positron Emission Tomography and a molecule tagged with radioactivity. We predicted that if you could see these differences cross-sectionally, then their presence might also predict suicidal behavior and its lethality in the future. Our study showed that those with higher serotonin 1a binding in the raphe nuclei, which likely indicates low serotonin functioning, made more medically damaging suicide attempts in the two years that followed. They also suffered from more pronounced suicidal ideation in the subsequent year.
22 Jul Women Still Getting CA-125 and CT Testing After Ovarian Cancer, Despite Lack of Clear Benefit
Posted at 00:39h
in Author Interviews, Beth Israel Deaconess, Biomarkers, Cost of Health Care, Medical Imaging, Ovarian Cancer
MedicalResearch.com Interview with:
[caption id="attachment_26310" align="alignleft" width="120"]
Dr. Katharine M. Esselen[/caption]
Katharine Mckinley Esselen, M.D.
Instructor in Obstetrics, Gynecology and Reproductive Biology
Beth Israel Deaconess Medical Center
Brigham and Womens Hospital
MedicalResearch.com: What is the background for this study?
Response: There is no consensus on how to follow a patient in remission from ovarian cancer in order to detect recurrent disease. However, a 2009 randomized clinical trial demonstrated that using CA-125 blood tests for routine surveillance in ovarian cancer increases the use of chemotherapy and decreases patient’s quality of life without improving survival compared with clinical observation. Published guidelines categorize CA-125 tests as optional and discourage the use of radiographic imaging for routine surveillance. Thus, this study aims to examine the use of CA-125 tests and CT scans at 6 Cancer Centers and to estimate the economic impact of this surveillance testing for ovarian cancer.
19 Jul Breast Density Interpretation Varies Among Radiologists
MedicalResearch.com Interview with:
Brian L. Sprague, PhD
Assistant Professor
Department of Surgery
Assistant Professor
Department of Biochemistry
University of Vermont
MedicalResearch.com: What is the background for this study?
Response: Having dense breasts makes mammography more difficult to interpret and is also an independent risk factor for developing breast cancer. About half of all U.S. states require that information on the density of a woman's breasts be made available to her after a mammogram, and in some states the report must also inform such women that there are additional tests, such as breast magnetic resonance imaging (MRI), that may detect breast cancer in women who have dense breasts and normal mammograms.
Such laws are controversial because of the large number of women affected (around 40% of women aged 40-74) and due to a lack of consensus in the medical community regarding the benefits and harms of supplemental screening strategies. An additional concern is the subjective nature of breast density assessment, which is based on the Breast Imaging Reporting and Data System (BI-RADS) that provides four possible categories for breast density.
13 Jul Analysis of Multiple MRI and PET Images Detects Earliest Signs of Alzheimer’s Disease
MedicalResearch.com Interview with: [caption id="attachment_26102" align="alignleft" width="200"]
Dr. Y. M. Medina[/caption]
Dr. Yasser Iturria Medina PhD
Post-doctoral fellow
Montreal Neurological Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We used over 200 peripheral molecular biomarkers, five different neuroimaging modalities and cognitive/clinical measurements to detect spatiotemporal abnormalities in subjects with dementia or with mild signs of cognitive deterioration. By means of a mathematical framework, we reordered all the biomarkers/descriptors considered, according to how much they change during the disease process. The results suggested that, contrary as suggested by more traditional clinical analyses, there are multiple early signs of neurodegeneration, at the molecular level and at the brain’s macroscopic and cognitive state. In particular, we observed notable early signs of generalized vascular dysregulation, which may be supporting the vascular hypothesis of Alzheimer’s disease. However, we still need to perform deeper analyzes, in order to clarify the complex causal mechanisms that trigger the disease.
13 Jul Coronary CT Able To Exclude Significant CAD in Patients Scheduled for Valve Surgery
MedicalResearch.com Interview with: [caption id="attachment_26076" align="alignleft" width="150"]
Dr. Maksymilian Opolski[/caption]
Dr Maksymilian P. Opolski
Department of Interventional Cardiology and Angiology
Institute of Cardiology
Warsaw, Poland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Valvular heart disease (VHD) that requires surgery is increasingly encountered in industrialized countries. Of particular interest, the presence of concomitant coronary artery disease (CAD) in patients with VHD is related to worse clinical outcomes, and various clinical studies suggested that combined valve and bypass surgery reduces early and late mortality. Consequently, in the majority of such patients, pre-operative evaluation for coronary artery disease (CAD) with invasive coronary angiography is recommended. However, provided that most patients with valvular heart disease are found to have no significant coronary stenoses, coronary computed tomography angiography (coronary CTA) appears as an extremely appealing noninvasive alternative to invasive coronary angiography for exclusion of significant CAD. This is further justified when the risks of angiography outweigh its benefits (e.g. in cases of aortic dissection or aortic vegetation).
12 Jul MRI Images Demonstrate Why Drinking Water Sometimes Curbs Appetite
MedicalResearch.com Interview with: [caption id="attachment_26058" align="alignleft" width="160"]
Guido Camps[/caption]
Guido Camps, MSc PhD candidate
Wageningen University and Research Centre
The Netherlands
Editor's note: The researcher would like readers to be aware that this work is preliminary and has not yet been published in a peer-reviewed journal.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background was that we wanted to study gastric distension with actual food. Because using different foods would also change the caloric content, we added water. We wanted to see if we could measure both the stomach and the brain, and what the added distension would feel like to the subjects and what brain effects we could see.
06 Jul No Increased Risk of Parkinson’s From MRI Gadolinium Exposure
MedicalResearch.com Interview with: [caption id="attachment_25906" align="alignleft" width="115"]
Dr. Blayne Welk[/caption]
Blayne Welk, MD, MSc,FRCSC
Assistant Professor of Surgery
Western University
London, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Prior research has demonstrated that gadolinium, which may be used during MRI scans to help visualise the body organs, can be deposited in the body, and remain there for years. The US FDA released a notice last year stating that further research was needed to evaluate the clinical implications of these brain deposits. One of the areas that gadolinium is deposited is the brain, specifically in two regions which control voluntary movement (the globus pallidus and dentate nucleus). Damage to these areas could cause symptoms of Parkinsonism. We used administrative data from Ontario, Canada to evaluate whether people who underwent MRI scans with gadolinium had a higher risk of developing Parkinsonism in the future. In this study, we did not demonstrate an increased risk of Parkinsonism in patients exposed to gadolinium.
03 Jul Knowledge of Risks From Imaging Radiation Has Room For Improvement
MedicalResearch.com Interview with: [caption id="attachment_25779" align="alignleft" width="100"]
Dr. David Leswick[/caption]
David Leswick MD FRCPC
Radiologist Saskatoon Health Region and the
University of Saskatchewan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background for this study is that the use of computed tomography (CT) is increasing, and there is a significant radiation dose imparted to the population through imaging. There have been multiple prior studies showing limited knowledge of both dose levels and its associated risk from medical imaging procedures, and we wanted to evaluate local knowledge in our Health Region. We surveyed a total of 308 health care providers, including 217 referring physicians, 32 radiologists and 59 technologists. Overall, most respondents were aware of the risk of malignancy from CT, with only 23% of physicians, 3% of radiologists, and 25% of technologists believing there was no increased risk of malignancy from a single CT scan. Underestimating radiation dose levels from a procedure is more concerning than overestimating as it may lead to minimization of the perceived risk. Although relatively few respondents (20%) selected the most appropriate dose estimate for an abdominal CT scan in chest x-ray equivalents, the majority (54%) correctly or overestimated dose, with better knowledge amongst radiologists and imaging technologists than referring physicians. In general, respondents were appropriately more concerned regarding radiation dose when imaging pregnant and pediatric patients as risks from radiation are higher in those groups of patients.
01 Jul GW Radiologist Discusses Implications of Breast Density Notification Laws
MedicalResearch.com Interview with: [caption id="attachment_25725" align="alignleft" width="196"]
Dr. Rachel Brem[/caption]
Rachel Brem, MD
Professor of Radiology and
Director of Breast Imaging and Intervention
George Washington University School of Medicine.
MedicalResearch.com Editor’s note: Many states now have laws regarding patient notification of breast density after mammography screening.
Dr. Brem discusses the background and implications of the new mandatory notification laws.
MedicalResearch.com: What is meant by 'breast density?’ Is breast density a risk factor for breast cancer? Is breast cancer more difficult to detect in dense breasts?
Dr. Brem: Breast density is a measure used to describe the proportion of fat versus breast tissue, which includes fibrous and glandular tissue. Dense breasts contain more fibrous and glandular tissue and less fatty tissue. This is important because on a mammogram dense breast tissue is white and breast cancer is white. The lack of contrast can make detecting cancer more difficult.
You can only tell if your breasts are dense from the mammogram. You can’t feel dense breast tissue or see it.
An estimated 40 percent of women have dense breast tissue that may mask the presence of cancerous tissue in standard mammography. Dense breast tissue decreases with age, but remains important throughout life. Over 75 percent of women in their 40s have dense breast tissue but over a third of women in their 70s have dense breast tissue.
As breast density increases, mammography sensitivity decreases. This is significant, but we must consider the increased risk of breast cancer in women with dense breast tissue. Women with dense breast tissue have up to a four-fold increased risk of developing breast cancer. So, breast density is essentially the “perfect storm” where the ability to detect cancer decreases while the risk for breast cancer increases. Therefore, optimal approaches to individualized breast cancer screening are needed.
24 Jun Breast Cancer Surgery Can Be Improved By Turning Patient Over For MRI
Posted at 15:29h
in Author Interviews, Breast Cancer, Brigham & Women's - Harvard, MRI, Surgical Research
MedicalResearch.com Interview with:
[caption id="attachment_25507" align="alignleft" width="120"]
Dr. Eva Gombos[/caption]
Eva C. Gombos, MD
Assistant Professor, Radiology
Harvard Medical School
Brigham and Women’s Hospital
MedicalResearch.com: What is the background for this study?
Response: Treatment of early stage breast cancer, breast-conserving therapy (BCT), which consists of lumpectomy followed by whole-breast irradiation, requires re-excision 20 %–40% of patients due to positive margins.
Breast MR is the imaging modality with the highest sensitivity to detect breast cancer. However, patients who undergo breast MR imaging have not experienced reduced re-excision or improved survival rates.
Our hypothesis is that supine (performed with patient lying on her back) MR imaging within the operating room can be used to plan the extent of resection, to detect residual tumor immediately after the first attempt at definitive surgery, and to provide feedback to the surgeon within the surgical suite. The aim of this study was to use intraoperative supine MR imaging to quantify breast tumor deformation and displacement secondary to the change in patient positioning from imaging (prone performed the patient lying on her stomach) to surgery (supine) and to evaluate the residual tumor immediately after BCT.
23 Jun PET-CT Scan Can Guide Treatment in Advanced Hodgkin’s Lymphoma
MedicalResearch.com Interview with: [caption id="attachment_25380" align="alignleft" width="150"]
Prof. Peter Johnson[/caption]
Peter Johnson MA, MD, FRCP
Professor of Medical Oncology
Cancer Research UK Centre
Southampton General Hospital
Southampton
MedicalResearch.com: What is the background for this study? What are the main findings?
Prof. Johnson: Based upon retrospective series looking at the ability of interim PET to predict the outcomes of treatment, we aimed to test the idea of modulating treatment in response to an early assessment of the response to ABVD: could we safely reduce the amount of treatment by omitting bleomycin in the group who had responded well? Although the risk of severe toxicity from bleomycin is generally low, for the small number of patients who experience it, it can be life-changing or even fatal. We also wanted to test whether it might be possible to reduce the use of consolidation radiotherapy by comparison to our previous trials, and this seems to have worked too: we used radiotherapy in less than 10% of patients in RATHL, as compared to around half in our previous trials. We have seen better survival figures than in our previous studies with less treatment overall, so it feels as though we are on the right track.
22 Jun MRI Brain Scans Can Predict Disruption of Blood-Brain Barrier in Stroke Patients
MedicalResearch.com Interview with: [caption id="attachment_25426" align="alignleft" width="200"]
Dr. Richard Leigh[/caption]
Dr. Richard Leigh MD
Neuro Vascular Brain Imaging Unit
National Institute of Neurological Disorders and Stroke
National Institutes of Health, Bethesda, MD
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Patients who suffer an ischemic stroke have limited treatment options. One of the reasons for this is that our treatments can sometimes make the stroke worse by transforming the ischemic stroke into a hemorrhagic stroke. In our study we identified a new piece of information that we can extract from the patient’s MRI scan that informs us on the risk of having a hemorrhage.
21 Jun Non-Contrast CT Yields Prognostic Findings in Hemorrhagic Stroke
MedicalResearch.com Interview with: [caption id="attachment_25254" align="alignleft" width="200"]
Dr. Gregoire Boulouis[/caption]
Dr. Gregoire Boulouis MD MS
Research Fellow at Massachusetts General Hospital / Harvard Med. School
Boston, Massachusetts
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Boulouis: Hemorrhagic Stroke or Intracerebral hemorrhage (ICH) still has a poor prognosis. A substantial proportion of patients will experience ongoing intracranial bleeding and their hematomas will grow in size in the first hours following presentation, a phenomenon called 'hemorrhage epxansion'. Patients with hemorrhage expansion have been shown to have significantly worse clinical outcome. If all baseline ICH characteristics (location, initial hemorrhage volume, ..) are non modifiable at the time of diagnosis, hemorrhage expansion, however, represents one of the few potential targets to improve outcome in ICH patients. An accurate selection of patients at high risk of expansion is needed to optimize patients' selection in expansion targetted trials and, eventually, to help stratifying the level of care at the acute phase.
In this study, we investigated whether the presence of non-contrast Computed Tomography hypodensities within the baseline hematoma, a very easily and reliably assessed imaging marker, was associated with more hemorrhage expansion.
A total of 1029 acute phase ICH patients were included ; approximately a third of them demonstrated CT hypodensities at baseline. In this population, CT hypodensities were independently associated with hemorrhage expansion with an odds ratio of 3.42 (95% CI 2.21-5.31) for expansion in fully adjusted multivariable model.