Study Examines Necessity of Additional Imaging in PET/CT Oncologic Reports

Radiologists and nuclear medicine physicians recommended additional imaging about 30% of the time in oncologic PET/CT reports, with about half of those recommendations being unnecessary, a new study shows.

The study, conducted at Brigham and Women’s Hospital in Boston, included 250 patients. The study found that there were 84 recommendations made for additional imaging. When study reviewers examined the patients’ records, they concluded that 43 of those recommendations were unnecessary, said Atul Shinagare, MD, one of the authors of the study. No adverse patient outcome would have occurred by not recommending additional imaging tests in these 43 cases, said Dr. Shinagare.

The study did not specifically address the motivating factors behind the recommendations for additional imaging, however “we feel that some of the most important factors leading to unnecessary recommendations include reluctance of physicians to accept uncertainty regarding diagnosis, partly driven by medicolegal concerns, combined with a failure to fully consider the patients’ clinical circumstances and the likely cost-effectiveness of additional imaging tests,” said Dr. Shinagare.

The study also found that 70% of the time, referring physicians did not follow through on the radiologists’ recommendation for additional imaging.

source: ARRS

MD Anderson Performs First MRI-Guided Brain Biopsy Using ClearPoint(R) System

MEMPHIS, Tenn., June 5, 2012 (GLOBE NEWSWIRE) -- MRI Interventions, Inc. (OTCBB:MRIC) today announced that the first MRI-guided brain biopsy using the company's ClearPoint® System has been performed at MD Anderson in Houston, Texas by neurosurgeon Dr. Ashwin Viswanathan, working with Dr. Sujit Prabhu. The MRI-guided brain biopsy represents the newest use of the ClearPoint System, which has already been successfully used by neurosurgeons in the United States for the insertion of electrodes and catheters in the brain.

MRI Interventions' ClearPoint System is an integrated system of reusable components, disposable components and intuitive, menu-driven software. It provides guidance for the placement and operation of instruments during neurological procedures performed within the magnetic resonance imaging (MRI) environment. Using the ClearPoint system, a physician sees and selects a neurological target, aims MRI Interventions' targeting device, and watches via MRI as the surgical instrument is advanced to the target. The ClearPoint system is intended to be used as an integral part of procedures, such as biopsies and catheter and electrode insertions, which have traditionally been performed using stereotactic methods, and the system is designed to allow those procedures to be performed in a hospital's existing MRI suite.

"The system worked well," said Dr. Prabhu. "The clear advantage is confirming the position of the needle tip prior to a biopsy and also identifying a safe trajectory to the lesion."

source: MRI Interventions

Breast MRI helps predict chemotherapy's effectiveness

OAK BROOK, Ill. – Magnetic resonance imaging (MRI) provides an indication of a breast tumor's response to pre-surgical chemotherapy significantly earlier than possible through clinical examination, according to a new study published online in the journal Radiology.

Women with breast cancer often undergo chemotherapy prior to surgery. Research has shown that women who receive this treatment, known as neoadjuvant chemotherapy, are more likely to achieve breast conservation than those receiving chemotherapy after surgery.

Clinicians track a patient's response to neoadjuvant chemotherapy through clinical measurements of the tumor's size and location. Contrast-enhanced MRI offers a promising alternative to the clinical approach through its ability to detect blood vessel formation in tumors, known as angiogenesis. Angiogenesis is an earlier and more accurate marker of tumor response.

"MRI was better than the clinical approach for predicting which patients would go on to have complete tumor response," said Nola M. Hylton, Ph.D., professor of radiology and biomedical imaging at the University of California in San Francisco. "It gave us great information on early response to treatment."

For the study, researchers analyzed data from ACRIN 6657, the imaging component of the multicenter Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging And moLecular Analysis (I-SPY TRIAL) breast cancer trial.

They compared MRI and clinical assessment in 216 female patients ranging in age from 26 to 68 years undergoing neoadjuvant chemotherapy for stage II or III breast cancer. MRI sessions were performed before, during and after administration of a chemotherapy regimen. The researchers correlated imaging results with subsequent laboratory analysis of surgical samples.

source: EurekAlert