Toshiba's Large Open Bore Mr System Improves Workflow At Overlake Hospital

TUSTIN, Calif., May 26, 2010 – Improving MR exam workflow without sacrificing patient safety, exam comfort or image quality is a goal for many health care facilities. Overlake Hospital in Bellevue, Wash., selected Toshiba America Medical Systems’ patient-friendly Vantage TitanTM ultra-short, open bore MR system to achieve this goal in its new MR facility.

Before acquiring the Titan, Overlake did not own an MR system and therefore was required to outsource all of its MR exams, a time-consuming and cumbersome experience for both the patient and physician. Since installing the Titan, Overlake patients receive MR exams immediately and on-site. In fact, the Titan’s ability to increase patient throughput because of its patient-friendly features enabled Overlake to exceed its patient volume projections shortly after installation.

“When planning our new MR department, we wanted to not only have around-the-clock access to MR exams and improve workflow, but also maintain Overlake’s focus on patient safety and comfort,” said Brenda Rinehart, director of Medical Imaging, Overlake Hospital. “The Titan’s features met and even exceeded these requirements. One example is the Titan’s large, open bore and noise reduction technology, which have improved the exam experience for our claustrophobic patients. This has resulted in a decrease in the need for sedation, allowing us to image patients more rapidly and safely.”

source: Toshiba Medical


MRI Research Highlights High-risk Atherosclerotic Plaque Hidden in the Vessel Wall

Researchers from Boston University School of Medicine (BUSM) have shown that use of magnetic resonance imaging (MRI) in an animal model can non-invasively identify dangerous plaques. The findings, which appear in the May issue of Circulation Cardiovascular Imaging, offer possible applications in the diagnosis and treatment of patients with atherosclerosis.

Rupture of vulnerable atherosclerotic plaque, which often occurs without prior symptoms, is responsible for a substantial number of deaths and disabilities worldwide. The untimely death of television journalist Tim Russert was caused by the sudden rupture of a vulnerable plaque in a critical location in a coronary artery. Identification of atherosclerotic plaques with a high risk for disruption and thrombosis would allow preventive therapy to be initiated before thrombi begin to clog arteries and cause stroke or heart attack.

The BUSM researchers examined diagnostic protocols in an animal (rabbit) model of human disease with procedures that never could have been applied to humans. Plaque disruption was stimulated at a precise time to allow MRI imaging before and after the rupture. According to researchers, plaques that were hidden within the vessel wall and pushing the vessel wall outward instead of occluding the lumen had a very high chance of forming a thrombus; plaques that caused vessel narrowing were almost always stable, which could explain why the most dangerous plaques generally escape detection by x-ray angiography. The study finds accurate, non-invasive MRI can identify these stable and unstable plaques.

source: Boston University School of Medicine


Symposium Focuses on Patient Safety in CT Scanning

ATLANTA, GA (May 13, 2010) -- A national summit of medical professionals meeting last month in Atlanta called for the creation of consensus scan techniques as a way of addressing the concerns of patients undergoing CT scans -- a common medical imaging procedure that uses X-rays to show cross-sectional images of the body.

The summit brought together some of the world's leading experts in CT imaging, including medical physicists, radiologists, technologists, and equipment manufacturers. It was hosted by the American Association of Physicists in Medicine (AAPM), a professional organization whose members include board-certified health professionals and research scientists specializing in the use of radiation in medicine.

According to Cynthia McCollough, Ph.D., Professor of Radiologic Physics at the Mayo Clinic, who co-organized the meeting on behalf of AAPM, the summit achieved its goal of identifying several issues that need to be dealt with by the medical imaging community in order to address the safety concerns of patients at U.S. hospitals and clinics.

In the last several months, many medical physicists have witnessed first-hand how some patients have grown concerned about stories in the media questioning the risks and challenging the safety of CT scans.

"We all hear it every day. Patients ask, 'do I really need to have this procedure?'," said Dianna Cody, Ph.D., another co-organizer of the meeting. Cody, who is Professor of Imaging Physics at the University of Texas M. D. Anderson Cancer Center, says that patients should not be afraid of getting medically appropriate CT exams. “When medically justified,” she said, “the benefits of CT scans far outweigh the risks.”

Even so, patients' fears are very real. The CT Dose Summit arose partly as a response to these fears, as leaders within the AAPM CT community discussed what more professionals in their field could do to ensure patient safety and to reassure patients coming for CT.

source: AAPM


Meet Phannie, NIST's Standard 'Phantom' for Calibrating MRI Machines

Magnetic resonance imaging (MRI)--a widely used medical tool that relies on magnetic fields and radio waves to visualize the body's internal structures, especially soft tissues--may soon become even more useful.

Phannie is the first “phantom” for calibrating magnetic resonance imaging (MRI) machines that is traceable to standardized values. The plastic sphere is about the size of a person’s head and filled with 100 smaller spheres used as contrast-enhancing agents and measurement reference markers. NIST researchers in Boulder, Colo., built Phannie and tested it on an MRI scanner at the University of Colorado Brain Imaging Center.

The National Institute of Standards and Technology (NIST) has unveiled the first “phantom” for calibrating MRI machines that is traceable to standardized values. The prototype, named Phannie, was developed in collaboration with the standards committee of the International Society for Magnetic Resonance in Medicine (ISMRM).

Traceable MRI calibrations are expected to enable accurate, quantitative measurements of tumors and other disease markers that can be reproduced across many different patients, scanners and clinics over time—and potentially reduce medical costs.

Displayed at the annual ISMRM meeting this past week,* the NIST phantom is a plastic sphere about the size of a person’s head, filled with water-bathed grids of 100 small plastic spheres containing various salt solutions that become magnetized in a magnetic field. By making MRI scans of Phannie, users can evaluate the image contrast, resolution, and accuracy of distance and volume measurements. A machine’s performance can be compared to standards, to other MRI machines, and to itself over time.

source: NIST


UF receives $7.5 million to study MRI as a tool for evaluating patients with Duchenne muscular dystrophy

GAINESVILLE, Fla. — Duchenne muscular dystrophy research at the University of Florida got a major boost with the award of $7.5 million in National Institutes of Health funding to study the use of magnetic resonance imaging in determining the natural progression of the disease.

UF scientists will assess whether MRI technology can be used as a precise, noninvasive measure of muscle tissue in children with Duchenne muscular dystrophy. Understanding how the disease affects muscle tissue could help facilitate the testing of new therapies in clinical trials, researchers say.

Duchenne muscular dystrophy affects about one of every 3,500 to 5,000 boys born each year in the United States, according to the Centers for Disease Control and Prevention. The disease causes the muscles that control movement to progressively weaken and lose the ability to regenerate after an injury, eventually replacing critical muscle tissue with fat and collagen. By age 12, many patients need a wheelchair. As the disease advances, the heart and respiratory system are affected and patients often die of cardiorespiratory failure in their 20s.

source: University of Florida


Preoperative MRI Assists in Surgical Planning and Helps Spare Erectile Function After a Robotic Assisted Laparoscopic Prostatectomy

Preoperative prostate magnetic resonance imaging (MRI) can help urologic surgeons spare the neurovascular bundle (NVB) (which controls a man’s erectile function and continence) during a robotic assisted laparoscopic prostatectomy (RALP) for the treatment of prostate cancer, according to a study to be presented at the ARRS 2010 Annual Meeting in San Diego, CA.

RALP is becoming increasingly common for the treatment of prostate cancer. “However it is limited by a lack of haptic feedback (loss of sense of touch), a component urologic surgeons use to evaluate the NVBs and determine if a nerve-sparing technique is possible,” said Timothy McClure, MD, lead author of the study. “Our study investigated the utility of MRI of the prostate in changing surgical decision making with regards to nerve sparring RALP,” said McClure.

The study, performed at the University of California, Los Angeles, included 104 men with biopsy proven prostate cancer who underwent preoperative MRI prior to RALP. “Twenty-nine out of 104 patients had the nerve sparring technique changed because of MR imaging. Of patients for whom the plan was changed, 49 percent underwent nerve sparing surgery and 40 percent had their plan changed to non-nerve sparing surgery,” said McClure.

source: ARRS


CT Technique Eliminates the Need for X-rays in Trauma Patients With Possible Spinal Fractures

When trauma patients receive a computed tomography (CT) scan of the chest, abdomen, and pelvis, a technique called CT spine reformatting eliminates the need for X-rays of the thoracic and/or lumbar spine to detect spinal fractures. This technique can lower cost and overall patient radiation exposure, according to a study to be presented at the ARRS 2010 Annual Meeting in San Diego, CA.

CT spine reformatting is performed by a CT technician after a CT scan is complete. It helps the radiologist assess the thoracic and/or lumbar regions of the spine without additional imaging, which can reduce cost and patient radiation exposure.

“Background research shows that CT is much more sensitive and specific than X-rays in detecting thoracic and lumbar spine fractures,” said Viesha Ciura, MD, lead author of the study. Our study looked at the percentage of trauma patients who had both reformatted CT data and X-rays of the thoracic and/or lumbar region of the spine and the additional radiation dose and cost associated with the unnecessary X-rays,” said Ciura.

The study, performed at the University of Calgary, Foothills Medical Centre, included 897 trauma CT scans with spine reformats. 19 percent of the patients with reformatted CT data showing the spine also had X-rays of the same segment of the spine. “In patients with spinal fractures detected on the CT spine reformats, the X-rays provided no additional information, and in fact, some of these fractures were not seen on the X-rays,” said Ciura. “Our calculations suggest that in every 1,000 trauma patients, the added radiation dose from spine X-rays that may not have been needed is 170 mSv; the additional cost per 1,000 trauma patients was $19,678.93,” she said.

source: ARRS


Non-Contrast HiSS MRI Performs Just as Well as Conventional Contrast-Enhanced MRI at Separating Benign and Malignant Breast Lesions

High spectral and spatial (HiSS) magnetic resonance imaging (MRI) — even when used without a contrast agent — matches the performance of conventional contrast-enhanced MRI at separating benign and malignant breast lesions, according to a study to be presented at the ARRS 2010 Annual Meeting in San Diego, CA. Contrast agents are used to enhance the image quality of an imaging exam.

HiSS MRI provides important functional and anatomical information that conventional MRI cannot. In addition, the image quality of HiSS MRI can be better than that of conventional MRI.

The study, performed at the University of Chicago in Chicago, IL, included 56 women who were imaged using both HiSS and conventional MRI. “Results showed that HiSS MRI (without contrast agents) performed just as well in the task of separating benign and malignant lesions as conventional MRI (with contrast agents),” said Milica Medved, MD, lead author of the study. “The accuracy of both tests was higher than 0.8,” she said.

“Currently, HiSS is still part of a research effort, and is not in routine clinical practice yet. We are hoping to change that — in fact, we are in the process of initiating a multi-center imaging trial which, if successful, would pave the way for routine clinical applications of HiSS,” said Medved.

source: ARRS


Image Filters Improve Image Quality and Lower Patient Radiation Dose Associated With CT Scans

Adaptive image filters can lower the patient radiation associated with chest and abdominal computed tomography (CT) scans while significantly improving image quality, according to a study to be presented at the ARRS 2010 Annual Meeting in San Diego, CA.

Image filters are one of the tools used in image processing to lower image “noise” in low radiation dose CT. “As we lower the radiation dose, the CT images become “noisy” or speckled which makes it difficult to view the organs or the body structures in the image,” said Sarabjeet Singh, MD, lead author of the study. “Image filters allow us to effectively lower the radiation dose without sacrificing the image clarity,” said Singh.

The study, performed at Massachusetts General Hospital in Boston, MA, included 12 patients who received a CT scan at four different levels of radiation dose in the chest and abdomen. All low dose images were processed with adaptive filters, and “regardless of radiation dose, post processing with image filters improved subjective noise for both chest and abdominal CT and helped lower the CT radiation dose levels for chest by up to 40 mAs and for the abdominal CT by up to 100 mAs,” said Singh.

“With the increasing use of CT, radiation dose concerns have been rising in the medical community, patients, as well as the media. Hence various efforts have been made to lower the radiation dose associated with CT scanning,” he said.

source: ARRS