Author Interviews, Cost of Health Care, Medical Imaging, NIH / 11.04.2014

Jamie Hui, MD Center for Health Services Research Virginia Mason Medical Center Seattle, WashingtonMedicalResearch.com Interview with: Jamie Hui, MD Center for Health Services Research Virginia Mason Medical Center Seattle, Washington MedicalResearch.com: What are the main findings of the study? Dr. Hui: Through a quality improvement intervention aimed at how radiologists report on findings in female pelvic ultrasound examinations, we were able to decrease the number of unnecessary recommendations for follow-up imaging of benign adnexal cysts, preventing duress for these women. (more…)
Author Interviews, Cognitive Issues, Medical Imaging, NIH / 07.04.2014

MedicalResearch.com Interview with: dr_Aalex_d_leowAlex Leow, MD PhD Psychiatric Institute Chicago, IL 60612 and   Tony J. Simon, PhD University of California, Davis MIND Institute Sacramento, CA 95817Tony J. Simon, PhD University of California, Davis MIND Institute Sacramento, CA 95817 MedicalResearch.com: What are the main findings of the study? Answer: Fragile X syndrome (FXS) is the most common inherited cause of intellectual disabilities and the most prevalent known single-gene cause of autism in males. The fragile X mental retardation 1 gene (FMR1) can be mutated with expanded numbers of CGG trinucleotide repeats in the 5’ untranslated region on the Xq27.3 site of the X chromosome. Normally, unaffected individuals have fewer than 45 CGG repeats in FMR1. When the size of the CGG repeat exceeds 200 FMR1 is silenced and the mutation is categorized as full, generating the FXS phenotype. If the expansion is between 55–200 repeats, then the individual is generally classified as a fragile X premutation carrier (fXPC). An estimated 40% of male and 8-16% of female premutation carriers later develop Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS), which is a late-onset (usually 50-70 years old) neurodegenerative disorder. We recruited 46 neurologically symptomless young to middle aged carriers of the FMR1 gene mutation. They were age and gender matched with 42 unaffected control individuals without the gene mutation. Both groups were evaluated by cognitive testing as well as novel neuroimaging techniques termed “brain connectomics,” based on diffusion tensor imaging (DTI) whole-brain tractography.  A connectome is a comprehensive map, like a wiring diagram, of neural connections in the brain. Our study is the first-ever connectome study to compare fXPCs and controls. In short, brain connectomics enable scientists for the first time to study the global organizational properties of the human brain by applying cutting edge computational techniques, based on graph theory, to these comprehensive maps of neural connections (i.e., the brain graphs). Our main finding was that, in neurologically symptomless male carriers  we detected a correlation between brain graphs’ efficiency in processing information and the number of CGG repeats in the mutated region of FMR1 (we estimated that each additional CGG repeat that in these males represents an effective increase of ~1.5 years  of “brain aging”). The correlation may prove to be an effective marker of early brain aging in otherwise neurologically symptomless premutation carriers. The study also further confirmed previous findings of smaller brain stem volumes in male fXPCS than in male controls. (more…)
Author Interviews, CT Scanning, Lancet, Medical Imaging, MRI, Pediatrics, Stanford / 20.02.2014

Dr Heike Daldrup-Link Associate Professor of Radiology Stanford University School of Medicine, Palo AltoMedicalResearch.com: Interview with: Dr Heike Daldrup-Link Associate Professor of Radiology Stanford University School of Medicine, Palo Alto   MedicalResearch.com: What are the main findings of the study? Answer: We use magnetic resonance imaging, a technology based on magnetic fields rather than radiotracers or x-rays. The underlying technology is not new – it has been used for tumor staging for many years. This is an advantage as MR scanners are available in nearly every major Children’s Hospital where children with cancer are treated. What is new about our approach is that we combined anatomical and functional images, similar to current approaches that use radiotracers and CT (PET/CT):  We first acquired scans that showed the anatomy of the patient very well and we then acquired scans that depict tumors as bright spots with little or no background information. We did that by using an iron supplement as a contrast agent: The iron supplement can be detected by the MRI magnet and improved tumor detection and vessel delineation MR scans. We then fused the anatomical scans with the tumor scans. (more…)
Author Interviews, BMJ, Breast Cancer, Mammograms / 13.02.2014

Anthony Miller, MD Director, Canadian National Breast Screening Study Professor Emeritus, Dalla Lana School of Public Health University of TorontoMedicalResearch.com Interview with: Anthony Miller, MD Director, Canadian National Breast Screening Study Professor Emeritus, Dalla Lana School of Public Health University of Toronto MedicalResearch.com: What are the main findings of the study? Prof. Miller:  The study involved 89,835 women aged 40 to 59. All underwent an annual physical breast examination, while half were randomly assigned to undergo annual mammograms for five years, beginning in 1980. During the five-year screening period, 666 invasive breast cancers were diagnosed in the mammography arm and 524 in the controls.  Over the 25 year follow-up 180 women in the mammography arm and 171 women in the control arm died of breast cancer.  The overall hazard ratio for death from breast cancer diagnosed during the screening period associated with mammography was 1.05 (95% CI: 0.85 – 1.30).  The findings for women aged 40-49 and aged 50-59 were almost identical. After 15 years of follow-up an excess of 106 cancers was observed in the mammography arm, attributable to over-diagnosis, i.e. 22% of screen-detected invasive breast cancers, half of those detected by mammography alone. This represents one over-diagnosed breast cancer for every 424 women screened by mammography. By 2005, 3,250 of the 44,925 women in the mammography arm of the study were diagnosed with breast cancer, and 500 had died of it. The control group of 44,910 women had 3,133 breast cancer diagnoses and 505 breast cancer deaths. We conclude that annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. (more…)
Annals Internal Medicine, Author Interviews, CT Scanning, Lung Cancer / 31.12.2013

dr_harry_j_dekonigMedicalResearch.com Interview with: Harry J de Koning, MD PhD Professor of Public Health & Screening Evaluation Rotterdam, The Netherlands. MedicalResearch.com: What are the main findings of the study? Dr. de Koning: Annual CT screening for lung cancer has a favorable benefit-to-harm ratio for individuals ages 55 through 80 years with 30 or more pack-years’ exposure to smoking. It would lead to 50% (model ranges, 45% to 54) of cases of cancer being detected at an early stage (stage I/II), 575 screenings examinations per lung cancer death averted, a 14% (range, 8.2% to 23.5%) reduction in lung cancer mortality, 497 lung cancer deaths averted, and 5250 life-years gained per the 100 000-member (1950-) cohort. Harms would include 67 550 false-positive test results, 910 biopsies or surgeries for benign lesions, and 190 overdiagnosed cases of cancer (3.7% of all cases of lung cancer [model ranges, 1.4% to 8.3%]), again for a 100 000-member (1950-) cohort. (more…)
Author Interviews, Heart Disease, Medical Imaging / 30.09.2013

Dr. Afshin Farzaneh-Far, M.D. University of Illinois at ChicagoMedicalResearch.com Interview with: Dr. Afshin Farzaneh-Far, M.D. University of Illinois at Chicago MedicalResearch.com: What are the main findings of the study? Answer: Traditionally SPECT MPI has been performed with adenosine which has a significant body of published prognostic data. Regadenoson is a selective A2A receptor agonist and is now the stress agent most widely used in the United States. Unlike adenosine, regadenoson is given as a bolus rather than as an infusion, simplifying the testing protocol and is better-tolerated. However, despite increasing use of regadenoson, there is very limited data on risk prediction using this agent. This study showed that the ability of SPECT MPI to predict heart attacks and death is the same for the new stress agent Regadenoson as it is for the old agent Adenosine. (more…)
CMAJ, Cost of Health Care, Duke, MRI, Orthopedics / 18.09.2013

Matthew P. Lungren, MD Duke University Medical CenterMedicalResearch.com Interview with: Matthew P. Lungren, MD Duke University Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Lungren: In the single center study, knee MRIs are more likely to be normal when the referring doctor has a financial stake in the imaging center or the equipment used; these data suggest that some of these examinations may be unnecessary. (more…)
Author Interviews, CMAJ, MRI, Stroke / 17.09.2013

Tobias Saam, MD Institute of Clinical Radiology Ludwig-Maximilians-Univ Hosp Munich, GermanyMedicalResearch.com Interview with: Tobias Saam, MD Institute of Clinical Radiology Ludwig-Maximilians-Univ Hosp Munich, Germany MedicalResearch.com: What are the main findings of the study? Dr. Saam: The results of our meta-analysis suggest that despite a large degree of detected heterogeneity of the published studies, the presence of intraplaque hemorrhage by MRI in patients with carotid artery disease is associated with an approximately 5.6-fold higher risk for cerebrovascular events, such as TIA or stroke, as compared to subjects without intraplaque hemorrhage. (more…)
Author Interviews, Diabetes, MRI, Nature, Stroke / 13.09.2013

Fabian Bamberg, MD, MPH Department of Clinical Radiology Ludwig Maximilians University, Klinikum Grosshadern Marchioninistrasse 15, 81377 Munich, GermanyMedicalResearch.com Interview with: Fabian Bamberg, MD, MPH Department of Clinical Radiology Ludwig Maximilians University, Klinikum Grosshadern Marchioninistrasse 15, 81377 Munich, Germany  MedicalResearch.com: What are the main findings of the study?  Dr. Bamberg: Our study shows that there is a substantial and heterogenous degree of subclinical cardiovascular disease burden in patients with diabetes undergoing whole-body MRI. These whole-body MRI findings have significant prognostic relevance. For instance, our results show that patients without any pathologic findings experience no adverse cardiovascular event over a period of six years while the risk for a heart attack or stroke increases with the degree of disease burden. (more…)
Author Interviews, Breast Cancer, MRI / 13.09.2013

Nariya Cho, MD Departments of Radiology Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.MedicalResearch.com Interview with: Nariya Cho, MD Departments of Radiology Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.   MedicalResearch.com: What are the main findings of the study? Dr. Cho: Smaller reduction in tumor volume and a smaller reduction in washout component on dynamic contrast agent–enhanced MR imaging assessed by computer-aided evaluation after neoadjuvant chemotherapy were independent parameters of worse recurrence-free survival and overall survival in breast cancer patients who received neoadjuvant chemotherapy. (more…)
Author Interviews, Cancer Research, CT Scanning, Heart Disease, JACC, Lung Cancer, Medical Imaging / 08.07.2013

Dr. Pim A. de Jong, Department of Radiology University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3508GA Utrecht, the Netherlands. MedicalResearch.com: What are the main findings of the study? Dr. de Jong: The main findings of the study is that lung cancer screening CT scans can predict future cardiovascular events. MedicalResearch.com: Where any of the findings unexpected? Dr. de Jong: The unexpected aspect is that the CT scans were not-ECG gated, but even these non-gated scans were good enough to quantify arterial calcifications and predict risk. (more…)
Author Interviews, CT Scanning, Medical Imaging, Neurological Disorders / 04.07.2013

 Dr. Juan Pablo Villablanca, MD Director, Neuroradiology Ronald Reagan UCLA Medical Center UCLA Medical Center, Santa MonicaMedicalResearch.com Interview with Dr. Juan Pablo Villablanca, MD Director, Neuroradiology Ronald Reagan UCLA Medical Center UCLA Medical Center, Santa Monica   The Natural History of Asymptomatic Unruptured Cerebral Aneurysms Evaluated Using CTA - Growth and Rupture Incidence and Correlation to Epidemiologic Risk Factors. MedicalResearch.com:  What are the main findings of the study?

Answer:   Our longitudinal study showed that growing aneurysms have a significantly higher risk of rupture than aneurysms that are stable in size over time. Due to this increased risk, we recommend that all aneurysms, regardless of size, should be followed regularly to look for growth. We have also found that larger aneurysm size, aneurysm growth and cigarette smoking may independently increase the risk of rupture. (more…)

Author Interviews, Lancet, Medical Imaging, MRI, Neurological Disorders / 03.07.2013

MedicalResearch.com Interview with: Dr Patrick Freund Spinal Cord Injury Center Balgrist University Hospital Zurich, University of Zurich Forchstrasse 380 8008 Zurich, SwitzerlandDr Patrick Freund Spinal Cord Injury Center Balgrist University Hospital Zurich, University of Zurich Forchstrasse 380 8008 Zurich, Switzerland MedicalResearch.com: What are the main findings of the study? Dr. Freund: Novel interventions targeting acute spinal cord injury (SCI) have entered clinical trials, but neuroimaging biomarkers reflecting structural changes within the central nervous system are still awaited. In chronic SCI, neuroimaging provided evidence of structural changes at spinal cord and brain level that could be related to disability. However, the pattern and time course of these structural changes and their potential to predict clinical outcomes is uncertain. In a prospective longitudinal study, thirteen patients with acute traumatic SCI were assessed clinically and by longitudinal MRI (within five weeks of injury, after two, six and twelve months) and were compared to eighteen healthy controls. Cross-sectional cord area, cranial white matter (CST) and grey matter (cortex) volume decrease was evident at baseline and progressed over twelve months. Multi-parametric mapping of myelin sensitive magnetization transfer (MT) and longitudinal relaxation rate (R1) was reduced both within and beyond the areas of atrophic changes. Better neurological and functional outcomes were associated with less atrophic changes of the CST in both cord and brain. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Cancer Research, CT Scanning, Medical Imaging, Medical Research Centers / 27.05.2013

prof_john_d_mathewsJohn D. Mathews, MBBS, MD, PhD, DSc Hon, DMedSc Hon, Professor of epidemiology at the School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians MedicalResearch.com: What are the main findings of the study? Prof Mathews: We found that for persons having at least one CT scan before the age of 20 years, and followed for an average period of 10 years, the average risk of cancer was increased by 24% compared with unexposed persons matched for age, sex and year of birth. The cancer risk increased by 16% for each CT scan that preceded the cancer by more than one year. The proportional increase in risk was greater for persons exposed at younger ages. (more…)
Author Interviews, Cancer Research, CT Scanning, Medical Imaging / 07.05.2013

MedicalResearch.com eInterview with Dr. Waël C. Hanna University of Toronto departments of Thoracic Surgery and Diagnostic Radiology, MedicalResearch.com: What are the main findings of the study? Dr. Hanna: By using Minimal Dose CT Scan (MnDCT) for surveillance of patients after lung cancer resection, we can detect 94.2% of recurrent or new lung cancer in this patient population. When we use chest x-ray (CXR) to conduct surveillance on the same cohort of patients, we can only detect 21.1% of new or recurrent lung cancer cases. Therefore, while MnDCT scan subjects the patient to a similar effective dose of radiation as CXR (0.2 mSV vs. 0.16 mSv), it is a vastly superior test for follow-up of this high risk population. More importantly, when we use MnDCT for surveillance, we can detect new or recurrent lung cancer at the asymptomatic locoregional stage in 78% of patients, and there quarters of those patients are candidates for further treatment in the form of surgery or radiation. In the patients who were treated, median survival was 69 months after initial operation, versus 25 months in those who received no treatment. (more…)
Author Interviews, JAMA, Medical Imaging, Mental Health Research, MRI / 26.04.2013

Medical Research.com eInterview with: Prof. Jean Decety PhD  Irving B. Harris Professor of Psychology and Psychiatry The University of Chicago 5848 S. University Ave. Chicago, IL 6063Prof. Jean Decety PhD Irving B. Harris Professor of Psychology and Psychiatry The University of Chicago 5848 S. University Ave. Chicago, IL 60637 - USA Faculty Web page: http://psychology.uchicago.edu/people/faculty/jdecety.shtml SCNL Web page: www.scnl.org Child NeuroSuite: www.childneurosuite.org MedicalResearch.com: What are the main findings of the study? Dr. Decety: In our study, psychopaths exhibited significantly less activation in the ventromedial prefrontal cortex, lateral orbitofrontal cortex, and brainstem relative to controls, but surprisingly showed greater activation in the insula.  The major difference in brain response between psychopaths compared to controls during the perception of others in pain was the lack of engagement of regions in the brainstem, orbitofrontal cortex (OFC) and ventromedial prefrontal cortex (vmPFC). (more…)
Author Interviews, Mammograms, Medical Imaging / 22.04.2013

Nancy L. Keating MD, MPH  Harvard Medical School Department of Health Care Policy 180 Longwood Avenue Boston, MA 02115-5899MedicalResearch.com eInterview with Nancy L. Keating MD, MPH Harvard Medical School Department of Health Care Policy 180 Longwood Avenue Boston, MA 02115-5899 MedicalResearch.com: What are the main findings of the study? Dr. Keating: We examined data from the 2005, 2008 and 2011 waves of the National Health Interview Survey (NHIS) a national population-based in person survey to assess whether mammography rates changed following the Nov 2009 USPSTF recommendations.   Prior to 2009 the USPSTF recommended routine screening every 1-2 years for all women older than 40 years old. In 2009, the USPSTF advised against routine mammography screening in women under 50, and recommended biennial screening for women 50-74. (more…)
Author Interviews, CT Scanning, Mayo Clinic, Medical Imaging, Orthopedics / 17.04.2013

MedicalResearch.com:  Katrina N. Glazebrook, MB, ChB Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 MedicalResearch.com:  Why did you do the study? Dr. Glazebrook: We felt CT was being underutilized for evaluation of knee injuries. The utility of CT has been well documented in the assessment of fractures, but little attention has been made on soft tissue evaluation. CT now has high spatial resolution with very thin reconstructions in any desirable plane, and we have previously noted that this allowed injured soft tissue structures such as cruciate ligaments to be well visualized [presented at Society of Skeletal Radiology meeting March 2013]. We had determined in that prior study that the best reconstruction plane to evaluate both normal and torn anterior cruciate ligaments was the oblique sagittal plane parallel to the lateral femoral condyle as routinely used in MRI imaging of the knee The soft tissue window, single energy bone removal and Dual energy bone removal were the best reconstructions to determine the presence or absence of ACL disruption The bone removal techniques removed the distracting bone so the soft tissue structures were more apparent. (more…)