Early Determination Of Effectiveness Of Cancer Treatment Using Quantitative PET Imaging

With positron emission tomography (PET) imaging, seeing is believing: Evaluating a patient's response to chemotherapy for non-Hodgkin lymphoma (NHL) typically involves visual interpretation of scans of cancer tumors. Researchers have found that measuring a quantitative index -- one that reflects the reduction of metabolic activity after chemotherapy first begins -- adds accurate information about patients' responses to first-line chemotherapy, according to a study in the October issue of the Journal of Nuclear Medicine.

"In our study, we demonstrated that a quantitative assessment of therapeutic response for patients with diffuse large B-cell lymphoma (DLBCL) is more accurate than visual analysis alone when using the radiotracer FDG (fluorodeoxyglucose) with PET scans," said Michel Meignan, professor of nuclear medicine at Henri Mondor Hospital in Creteil, France. "The ability to predict tumor response early in the course of treatment is very valuable clinically, allowing intensification of treatment in those patients who are unlikely to response to first-line chemotherapy," he added. "Similarly, treatment could possibly be shortened in those patients who show a favorable response after one or two cycles of chemotherapy, and quantification also may help identify the disease's transformation from low-grade to aggressive stage," he explained. "However, visual interpretation of PET scans will always be the first step of analysis and will prevail in case of difficulties to quantify images," added Meignan.

source - medicalnewstoday.com

MRI predicts liver fibrosis, study says

Moderate to severe chronic liver disease can be predicted with the use of diffusion-weighted MRI (DWI), according to a recent study conducted by researchers at New York University Medical Center in New York, NY.

Due to the increased incidence of chronic hepatitis in the United States, particularly hepatitis C, there is a strong need for non-invasive methods to replace or supplement liver biopsy, which is relatively invasive and limited by interobserver variability and sampling error, said Bachir Taouli, MD, lead author of the study. DWI appears promising in that purpose, although it needs validation in larger series, he said.

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First Live Patient Demonstration of Next Generation i-CAT(R) Cone Beam 3-D Imaging System

(BUSINESS WIRE)

Imaging Sciences International, the global leader in advanced dental and maxillofacial radiography products, and Henry Schein, Inc. (NASDAQ:HSIC - News), the largest provider of healthcare products and services to office-based practitioners in the combined North American and European markets, successfully participated in the first live patient demonstrations of the Next Generation i-CAT® 3-D dental imaging system at the 2007 American Dental Association (ADA) Annual Session in San Francisco, Calif.

The i-CAT® is the leader in Cone Beam 3-D imaging, producing anatomically accurate three-dimensional views of all mouth, face, and jaw anatomy. The i-CAT® is exclusively distributed by Henry Schein in the United States and Canada. The live patient 3-D imaging educational session, featuring the i-CAT®, demonstrated how Cone Beam 3-D imaging can be used to analyze patient anatomy and create the most accurate treatment plans for successful surgical procedures.

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Caution urged over overuse of CT scans in South Florida

By Bob LaMendola
South Florida Sun-Sentinel

The CT scan — a medical darling for its detailed images, diagnostic power and big profits — is being overused in South Florida and nationally so much that some experts worry the radiation may cause cases of cancer.

New reports this year assert that computed tomography scans expose patients to small but significant doses of radiation that can add up over time, findings that CT defenders dismiss as alarmist.

The reports warn doctors to limit CT radiation exposure to patients, especially children and small adults who are at elevated risk, and to use radiation-free ultrasound and magnetic resonance imaging (MRI) if possible.

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New thoracic imaging approach can pinpoint underlying venous problems

University of Cincinnati (UC) radiologists have developed a new technique for capturing images of chest veins that eases diagnosis of venous diseases.

Multi-detector computed tomography (CT) scanners are traditionally used to create three-dimensional images of arteries, the vessels which carry oxygen-rich blood away from the heart and distribute blood throughout the body. Veins, smaller vessels that return blood to the heart, are more difficult to accurately image.

Developed by Cristopher Meyer, MD and Achala Vagal, MD, the new protocol allows radiologists to compensate for the extra time it takes contrast solution to reach the veins so useful images can be produced using the CT scanner.

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MRI Is More Sensitive At Detecting Early Signs Of Breast Cancer Than Mammography

If used with appropriate diagnostic criteria, MRI is much more sensitive than mammography for detecting breast cancers before they have developed to an invasive stage, and particularly good at identifying those lesions which are more likely to progress to dangerous forms of cancer, according to a study published in The Lancet. This finding is in stark contrast to previous studies comparing the two techniques that concluded MRI can not detect early cancers as effectively as mammography.

Debates over which screening modality is best for detecting ductal carcinoma in situ (DCIS)---an early type of breast cancer in which cancerous cells are present but are confined to the milk ducts within the breasts---have in the past focused on identification of microcalcifications, small areas where cells have died and subsequently turned into calcium deposits, which are used as a hallmark of cancerous growth. Mammography can visualise these features in a breast scan whereas MRI cannot.

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A Breast Tumor's Response To Chemotherapy Can Be Accurately Detected By PET Scans

Researchers in Australia have shown that positron emission tomography (PET) that uses a radioactive sugar molecule is more useful than mammography and ultrasound in predicting a breast tumour's response to chemotherapy and, therefore, the patient's ultimate likelihood of survival.

In research presented at the European Cancer Conference (ECCO 14) in Barcelona, Dr Vinod Ganju reported that when the scanning procedure was used to measure the accumulation of radioactive glucose fluorodeoxyglucose (FDG) in tumour tissue from patients with locally-advanced breast cancer before and after preoperative chemotherapy, women who had the highest accumulation at the beginning and who then had the highest percentage drop in accumulation after four cycles of chemotherapy were more likely to have a complete response to their treatment i.e. no tumour cells remaining in the final tumour resection specimen. However, measurements taken using mammography or ultrasound were not able to predict a pathological response accurately.

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MR spectroscopy identifies breast cancer, reduces biopsies

OAK BROOK, Ill.—Proton magnetic resonance spectroscopy (¹H MRS) used in conjunction with magnetic resonance imaging (MRI) can aid radiologists in diagnosing breast cancer while reducing the number of false-positive results and invasive biopsies, according to a study focusing on non-mass enhancing breast lesions. The study, conducted at Memorial Sloan-Kettering Cancer Center in New York City, appears in the October issue of the journal Radiology.

“All of the cancers present in this study were identified with MR spectroscopy,” said the study’s lead author, Lia Bartella, M.D., director of breast imaging at Eastside Diagnostic Imaging in New York City.

The American Cancer Society estimates that 212,920 women will be diagnosed with breast cancer in the United States this year. MRI is playing an increasingly important role in the screening of women at high risk for breast cancer. However, while MRI depicts more abnormal findings than other breast screening procedures, it is not 100 percent accurate in distinguishing benign from malignant lesions, resulting in a large number of breast biopsy procedures recommended on the basis of imaging findings. Currently, approximately 80 percent of breast lesions biopsied are found to be benign.

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Radiologists identify early brain marker of Alzheimer's disease

Researchers using functional magnetic resonance imaging (fMRI) have found a new marker which may aid in early diagnosis of Alzheimer’s disease, according to a study published in the October issue of Radiology.

“The findings of this study implicate a potential functional, rather than structural, brain marker—separate from atrophy—that may help enhance diagnosis and treatment monitoring of Alzheimer’s patients,” said the study’s lead author, Jeffrey R. Petrella, M.D., associate professor of radiology at Duke University Medical Center in Durham, N.C.

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Cancer specialists warn EU directive puts MRI benefits at risk

MADRID (AFP) - Cancer researchers warned at a conference in Spain Monday that an EU directive on limiting magnetic resonance imaging (MRI) could halt use of an important tool in the fight against the disease.

The directive is set to be implemented across Europe by April next year and was drawn up to limit medical workers' exposure to electromagnetic fields.

But Professor Dag Rune Olsen, a specialist in experimental radiation therapy at the Norwegian Radiation Hospital in Oslo, told the European Cancer Conference in Barcelona that the directive could put at risk some eight million annual MRI scans, hampering patient treatment.

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Catheter Angiography May Be An Unnecessary Follow-up To CT Angiography

Science Daily — Even in challenging cases, CT angiography (CTA) offers an accurate and rapid diagnosis for blunt trauma victims who may have aortic or great vessel injury negating the need for more invasive procedures, according to a recent study conducted by radiologists at the University of Washington and the Harborview Injury Prevention and Research Center in Seattle, WA.

CTA is commonly used to rule out blunt aortic and intrathoracic great vessel injuries, but sometimes the results are indeterminate, said Marla Sammer, MD, lead author of the study. When the results are indeterminate, a subsequent catheter angiography is usually performed.

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Lung Cancer Alliance Stands Behind CT Screening For Lung Cancer

While the American College of Chest Physicians (ACCP) came out last week in opposition to CT screening for lung cancer, Lung Cancer Alliance (LCA) reiterated its support for the screening test which can detect lung cancer at its earliest most treatable stage for those at high risk.

"Mammograms for breast cancer faced enormous opposition for decades and there is still heated debate over screening of women under the age of 50. And there are reams of papers showing no mortality benefit for PSA testing for prostate cancer," said Laurie Fenton Ambrose, President of Lung Cancer Alliance.

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Bright Tumors, Dim Prospects

It doesn't matter how small or large it is, if a cervical tumor glows brightly in a PET scan, it's apt to be more dangerous than dimmer tumors. That's the conclusion of a new study of cervical cancer patients at Washington University School of Medicine in St. Louis.

"We've seen that among patients with the same stage of cervical cancer, there will be some patients who don't respond to treatment as well as others," says lead author Elizabeth A. Kidd, M.D., a Barnes-Jewish Hospital resident in Washington University's Department of Radiation Oncology. "Our study suggests that PET (positron emission tomography) can reliably identify patients who have a poorer prognosis."

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New Guidelines For Lung Cancer Oppose General CT Screening

New evidenced-based guidelines from the American College of Chest Physicians (ACCP) recommend against the use of low-dose computed tomography (LDCT) for the general screening of lung cancer. Published as a supplement to the September issue of CHEST, the peer-reviewed journal of the ACCP, the guidelines cite there is little evidence to show lung cancer screening impacts mortality in patients, including those who are considered at high risk for the disease. The guidelines also recommend against the use of vitamin or mineral supplements for the prevention of lung cancer, for these do little to decrease the risk of lung cancer, while beta-carotene has been associated with increased risk of lung cancer.

"Even in high risk populations, currently available research data do not show that lung cancer screening alters mortality outcomes," said W. Michael Alberts, MD, FCCP, chair of the ACCP lung cancer guidelines and Chief Medical Officer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. "We hope that one day, we can find a useful and accurate tool for general lung cancer screening, but, at this time, the evidence does not support the use of LDCT screening."

Medical News Today

Ongoing Training In CT Colonography Recommended For Gastroenterologists

Recognizing that CT colonography will play a role in screening for colorectal cancer (CRC), and the critical need to increase overall CRC screening rates, the American Gastroenterological Association (AGA) Institute issued minimum standards for gastroenterologist performance of the test. To ensure competence, a minimum of 75 endoscopically confirmed cases should be interpreted by the physician.

Despite the fact that CT colonography has not yet been endorsed as a primary screening test in asymptomatic, normal risk adults, many patients have shown interest in this test. The indications for CT colonography are controversial, with many payers recommending that this test only be indicated for patients who have had a failed optical colonoscopy or who have a mass obstructing the colon where examination of the entire colon is required prior to surgical resection. Nonetheless, CT colonography may be considered for patients unwilling to undergo other colorectal screening tests, note the authors of the standards paper, which is published in Gastroenterology, the official journal of the AGA Institute.

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New Imaging Technique Reveals Fatty Hearts in Pre-diabetics

(NewsRx.com) -- A simple imaging technique developed by UT Southwestern Medical Center researchers has revealed fat buildup in the hearts of pre-diabetic people long before symptoms of heart disease or diabetes appear.

The technique detects fat accumulation in cells of the beating heart in a way no other clinical method can, the researchers said, and may provide a way to screen patients for early signs of heart disease in diabetes.

“Hearts beat; people breathe; and magnetic resonance imaging is very sensitive to motion, so we had to find a way to electronically ‘freeze' the image of the heart,” said Dr. Lidia Szczepaniak, assistant professor of internal medicine at UT Southwestern and senior author of a study appearing in the Sept. 4 issue of Circulation.

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Greater Efficiency And Diagnostic Certainty In Cardiac MRI

Now functional cardiac analysis is performed even faster than before with magnetic resonance imaging (MRI) - thanks to a new software module from Siemens: the new "Inline Ventricular Function" (Inline VF) enables full automatic detection of heart contours and their motion during image acquisition. Physicists can accurately evaluate cardiac functioning immediately after the scan. Previously, the image data had to be transferred to post-processing consoles, and frequently contours had to be post-processed manually. Functional data are extremely important for the evaluation of myocardial infarction or myocarditis. They are also equally necessary when determining indications for ICD implants implantable cardioverter-defibrillator).

Inline VF is integrated as a software module directly into the acquisition sequence, enabling calculation of functional data already during image acquisition. The heart is localized on MR images automatically; the system detects the inner and outer contours and generates the functional data without additional mouse clicks. Already now MRI is the gold standard for functional cardiac diagnostics, the efficient workflow means that even more patients will be able to benefit from this radiation-free cardiological procedure.

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Alternative Method Of Urinary Tract Imaging Reduces Radiation Dose

The split-bolus (cross sectional imaging) MDCT urography technique reduces both radiation dose and number of images produced, according to a recent study conducted by radiologists from Stanford University School of Medicine in Stanford, CA and VA Palo Alto Health Care System in Palo Alto, CA.

"Since CT urography was first conceived, in the late 90s, there have been a multitude of protocols described in the literature. The vast majority of these protocols entail scanning patients before contrast and at multiple phases after the administration of IV contrast," said Lawrence C. Chow, MD, lead author of the study. "We wanted to show that a similar examination could be achieved with fewer scan acquisitions [meaning potentially less radiation and fewer images] by administering a split-bolus of IV contrast, without sacrificing sensitivity," he said.

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New MRI Finding Sheds Light On Multiple Sclerosis Disease Progression

Using magnetic resonance (MR) images of the brain, researchers have identified a new abnormality related to disease progression and disability in patients with multiple sclerosis (MS), according to a study published in the September issue of Radiology, published by the Radiological Society of North America (RSNA).

"Based on these findings, physicians may be able to diagnose multiple sclerosis more accurately and identify patients at risk for developing progressive disease," said the study's lead author, Rohit Bakshi, M.D., associate professor of neurology and radiology at Harvard Medical School and director of clinical MS-MRI at Brigham and Women's Hospital and Partners MS Center in Boston.

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Cardiac CTA reveals significant incidental disease beyond the heart

A study by University of Maryland researchers has found that CT angiography exams performed after coronary artery bypass surgery can help physicians identify unsuspected, clinically relevant cardiac and noncardiac conditions.

Imagers learned years ago that many patients undergoing electron beam CT of the heart also showed incidental cardiac and noncardiac disease warranting management. Tests like coronary artery calcium scoring without contrast media, for instance, now popular for use with multislice CT scanners, can show such findings.

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Multidetector CT Angiography Promising for Brain Aneurysm

DUISBURG, Germany, July 31 -- Multidetector CT angiography can diagnose and assess intracranial aneurysms with equivalent accuracy to digital subtraction angiography, investigators here reported.

Compared with DSA, the investigators found that multidetector CTA had a sensitivity of 98% and a specificity of 100% for detecting brain aneurysms, according to an article in the August issue of Radiology. In addition, multidetector CTA predicted the feasibility of endovascular treatment with 94% sensitivity and 92% specificity.

We conclude that multidetector CT angiography… can be used as the first step in the diagnostic workup of patients with subarachnoid hemorrhage," said Karsten Papke, M.D., of the Duisburg Clinic, and colleagues.

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Using MRI For Diagnosis Could Help Prevent Breast Cancer Progression

Using magnetic resonance imaging (MRI) to diagnose breast cancer in its intraductal stage could help prevent the development of invasive cancer, conclude authors of an Article in this week’s edition of The Lancet. And an accompanying Comment says that the findings show that MRI should now be used as a distinct method in its own right to detect breast cancer in its earliest stage.

Professor Christiane Kuhl, Department of Radiology, University of Bonn, Germany and colleagues studied 7319 women over a five-year period who had been referred to an academic breast centre. The women received MRI in addition to conventional mammography for diagnostic assessment and screening, with the aim of discovering the sensitivity of each method for diagnosing ductal carcinoma in situ (DCIS). Mammograms and MRI scans were then assessed independently by different radiologists, and the relative sensitivity of each method of detection was assessed by comparing the biological profiles of mammography-detected DCIS with those of MRI-detected DCIS.

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New Level of Effectiveness for CT Colonography Examinations

Siemens Medical Solutions is solidifying its presence at the forefront of the market for computer-assisted reading tools in CT colonography by today announcing the release of a new version of syngo® Colonography PEV (Polyp Enhanced Viewing), an automated second reader tool for the visualization of lesions in the colon.

The solution helps radiologists to detect polyp-shaped objects between 6 mm and 25 mm in size and can now be used both in clean-prepped and solid-liquid tagged protocols. With the new version, syngo® Colonography PEV delivers the benefits of computer-assisted reading to a wider range of protocols commonly applied in CT colonography today, including stool tagging agents. The PEV tool is seamlessly integrated into the syngo Colonography CT application.

Together with workflow-enhancing features such as Auto Polyp Measurements, the software improves reading accuracy as well as efficiency. The solution was developed using an extensive database of more than 1700 CT colonography cases from more than 15 clinical sites worldwide, and covers a variety of CT acquisition parameters and bowel preparation protocols.

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Study Cautions Use Of Cardiac CTA In Children

Cardiac-gated CTA radiation doses can vary and be as high as 28.4 mSv (10 times the annual natural background radiation) in children, according to a recent study conducted by researchers from Duke University Medical Center in Durham, NC and Stanford University Medical Center in Palo Alto, CA.

"This investigation evaluated the potential radiation dose of coronary CT angiography in pediatric patients," said Caroline Hollingsworth, MD of Duke University Medical Center, lead author of the study. "Since often adult technologies and techniques are simply applied to children, we were interested in assessing what the dose could be," she said.

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Siemens Unveils World's First High Definition PET-CT, Providing Unprecedented Clarity Through Entire Field Of View

Just as the clarity of high definition television has transformed the entertainment world, Siemens Medical Solutions is redefining the quality of molecular imaging with the introduction of high definition positron emission tomography. Siemens has unveiled HD PET, the world's first and only high definition PET technology to offer consistently sharper and clearly defined images across the entire field of view beginning of June 2007 in the USA. "As the leading innovator in molecular imaging, Siemens raises the bar in innovation yet again by adding high definition to the Biograph TruePoint family of hybrid PET CT systems," said Michael Reitermann, president, Molecular Imaging, Siemens Medical Solutions. "The clarity of HD PET will provide greater specificity and accuracy and will enable physicians to more confidently delineate small lesions - including those in lymph nodes, abdomen, head and neck, and brain- to provide earlier, more targeted treatment."

The clarity achieved by HD PET is the result of a unique and proprietary technology that optimizes the elements of image uniformity, resolution and contrast - that together change the whole picture." The uniform resolution provided by HD PET throughout the field-of-view is a significant step in improving PET image quality," said David Townsend, PhD, director, Molecular Imaging and Translational Research Program, University of Tennessee Graduate School of Medicine, who has worked with Siemens while testing the new HD PET technology. "Historically with PET imaging, intrinsic image quality has been known to degrade with increasing distance from the center of the scanner. HD PET eliminates this effect thus providing increased diagnostic confidence to more accurately resolve peripheral lesions. This, in turn, could potentially improve staging of disease and hence clinical outcome."

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PET Scan Shows During Treatment If Radiation Is Shrinking Lung Tumor

Lung cancer patients may not need to wait till their radiation treatment is over to know if it worked. A PET scan several weeks after starting radiation treatment for lung cancer can indicate whether the tumor will respond to the treatment, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center.

Traditionally, PET, or positron emission tomography, has been used after radiation treatment for lung cancer to assess whether the tumor responded to treatment and whether the patients will have a chance of being cured. Using PET several weeks into treatment, researchers found a strong correlation between tumor responses during treatment and response three months after completion of the treatment. This could potentially allow doctors to change the radiation treatment plan before treatment ends to improve the outcome.

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Physicians Who Use FONAR UPRIGHT(TM) MRI Testify to the Unique Benefits

MELVILLE, NY -- 07/12/07 -- FONAR Corporation (NASDAQ: FONR), The Inventor of MR Scanning(TM), reported today that physicians who use the FONAR UPRIGHT(TM) MRI are testifying to the unique benefits of the technology in patient care. They are appearing in 2-page color advertisements in the peer-reviewed journal 'Radiology,' published by the Radiologic Society of North America.

The physicians are introduced with the headline, "Why So Many Surgeons Are Buying the FONAR UPRIGHT(TM) MRI." Then they speak for themselves.

The testimonials of the prominent surgeons and leading radiologists are also appearing in advertisements in numerous other major medical magazines, including The Journal of the American Medical Association, Spine, Radiology, Diagnostic Imaging, The Journal of the American Academy of Orthopedics and the Journal of Neurology.

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PET-CT Scanners Prone To Generating False-Positive Results In Atherosclerosis

Current PET-CT scanners with standard commercial software designed to provide images of the heart are falsely indicating coronary artery disease in as many as 40 percent of patients, according to a study published on the cover page of the Journal of Nuclear Medicine.

Lead author K. Lance Gould, M.D., professor in the Division of Cardiology at The University of Texas Medical School at Houston, said he discovered the abnormalities upon his initial use of cardiac PET-CT scanners in the Weatherhead P.E.T. Center For Preventing and Reversing Atherosclerosis at Memorial Hermann-Texas Medical Center.

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