Table of Contents

November 2009; 253 (2)

Science to Practice

  • On the basis of the results of the animal study performed by Jansen et al and clinical observations, there is compelling evidence to suggest that the imaging phenotype of a ductal carcinoma in situ (DCIS) lesion (its detectability at mammography and MR imaging, specifically the presence or absence of calcifications on mammograms and the presence or absence of calcifications and the degree of their enhancement on MR images) conveys important biologic information that will be useful when guiding DCIS treatment.

Communications

Letters to the Editor

Reviews and Commentary

Editorial

  • The need to be infallible creates a strong pressure to intellectual dishonesty, to cover up rather than to admit mistakes.

  • We thought it would be helpful to our authors to summarize our suggestions for avoiding a number of the most common errors and problem issues in statistical analysis that we encounter in submissions to Radiology.

    © RSNA, 2009

  • Whether recommendations for additional imaging in radiology reports are considered self-referral or good clinical practice depends on the appropriateness of both the original and recommended additional procedures, which can only be determined through good outcomes studies.

    © RSNA, 2009

  • Americans were exposed to more than seven times as much ionizing radiation from diagnostic medical procedures in 2006 than they were in the early 1980s.

Review for Residents

  • Ultimately, if a lesion cannot be characterized as a benign entity, it should be reported as indeterminate, and the patient should undergo biopsy to exclude malignancy.

State of the Art

  • In this review we focus on clinical, radiologic, and pathologic aspects of subsolid pulmonary nodules, with the intention to propose new interim management guidelines.

Book Reviews

Original Research

Breast Imaging

  • Standardization of b values allows improved interstudy comparisons on the diagnostic accuracy of diffusion-weighted MR breast examinations.

  • Results indicate that with full-field digital mammography (FFDM) using computer-aided diagnosis (CAD) and double reading, the detection is as good as that with screen-film mammography, and detection of clustered microcalcifications and ductal carcinoma in situ is improved with FFDM using CAD.

Cardiac Imaging

  • Because characteristic well-circumscribed foci of fat attenuation were found in the majority of patients with tuberous sclerosis complex and not in the control group, such fatty foci may help identify patients suspected of having the disease.

  • Measurements of interventricular mechanical dyssynchrony obtained by using velocity-encoded MR imaging are equivalent to measurements obtained with pulsed-wave echocardiography and can be used to identify potential responders to cardiac resynchronization therapy.

Contrast Media

  • The severity of a breakthrough reaction is usually similar to the severity of the index reaction, and most injections in premedicated patients do not result in a repeat breakthrough reaction.

Experimental Studies

  • CT-determined specific gas volume and hyperpolarized 3He MR imaging–determined gas density allowed quantitative separation of normal regions and those with trapped gas.

  • This study demonstrates that the combination of erythropoietin and intravenous iron worsens the severity of skin lesions in rats treated with high-dose gadodiamide, as measured by dermal cellularity and deposition of gadolinium.

  • We used a transgenic mouse model of breast cancer to investigate contrast enhancement of ductal carcinoma in situ (DCIS) on clinical dynamic contrast material–enhanced (DCE) MR images of the breast, and we have shown via two independent routes—DCE MR imaging and x-ray fluorescence microscopy—that after injection of gadodiamide, there is gadolinium uptake inside ducts distended with murine DCIS.

Gastrointestinal Imaging

  • Definitive diagnosis of peritoneal metastasis (PM) could not be made in 71.7% (38 of 53) of patients proved to have PM at surgery.

  • Besides the classical reversed jejunoileal fold pattern, CT enteroclysis shows a constellation of findings in association with uncomplicated celiac disease.

Genitourinary Imaging

  • MR imaging findings may represent additional useful variables for predicting the disease extent in patients with clinically localized prostate cancer.

Head and Neck Imaging

  • We found that perfusion measurements in the thyroid obtained by using a flow-sensitive alternating inversion recovery with steady-state precession MR technique revealed significantly elevated perfusion values in patients with autoimmune thyroid disorders compared with perfusion values in healthy control subjects and significantly elevated perfusion in patients with Graves disease compared with that in patients with Hashimoto thyroiditis.

Health Policy and Practice

  • Closing the gap between patients’ expectations that harmful errors will be disclosed to them and current practice requires understanding the unique challenges that individual specialties, such as radiology, face related to disclosure, and using this information to help physicians communicate with patients more effectively following errors.

  • There has been a general increase in the tendency for radiologists in our practice to recommend additional or follow-up imaging; the odds ratio of 2.16 (95% confidence interval: 2.11, 2.19) between 1995 and 2008 was estimated from a logistic regression which holds all other factors equal.

Molecular Imaging

  • If molecular imaging is performed with high doses of diagnostic probes, biologic effects must be considered that can be highly divergent between different cells and may even include loss of cell adhesion and endocytotic activity.

Neuroradiology

  • Our preliminary results demonstrate a good flexibility and efficacy of the Willis covered stent in the treatment of distal internal carotid artery aneurysms in selected patients.

  • A training effect is evident among novice operators and manifests as subtle improvements in resource utilization (cement use) and postprocedural outcome scores (pain at rest, Roland-Morris Disability Questionnaire score), but not among long-term outcomes or mean clinical outcome scores.

  • In this study, we showed that quantitative measurement of hemodynamic values derived from T2*-weighted dynamic susceptibility-weighted contrast material–enhanced MR imaging results can be used to distinguish recurrent glioblastoma multiforme from external beam radiation therapy–induced necrosis.

  • The iron concentration of the parietal cortex was significantly positively correlated with the severity of cognitive impairment in patients with Alzheimer disease, indicating that it may be used as a biomarker to evaluate the progression of Alzheimer disease.

  • Tumor growth within 6 months was better than baseline volumes, relative cerebral blood volume, or apparent diffusion coefficient in predicting time to malignant transformation in untreated low-grade gliomas and was independent of other parameters, including histologic findings.

Pediatric Imaging

  • CT predictors for differentiating benign versus clinically worrisome causes of pneumatosis intestinalis include soft-tissue thickening of the bowel wall, free intraperitoneal fluid, extent of PI, and periintestinal soft-tissue stranding.

Special Report

  • The per-capita annual effective radiation dose from medical procedures in the United States is among the highest in the world and is estimated to have increased sixfold from about 0.5 mSv in 1980 to 3.0 mSv in 2006.

Technical Developments

  • A method for distinguishing and displaying the arrival times of intravenously administered contrast material in a vascular territory, as determined with three-dimensional time-resolved contrast-enhanced MR angiography, is presented.

Ultrasonography

  • CT was more accurate than Doppler US in the diagnosis of right hepatic vein stenosis in symptomatic patients after living donor liver transplantation; complementary use of CT should be considered when right hepatic vein stenosis is suspected at Doppler US to reduce the incidence of unnecessary invasive venography.

Vascular and Interventional Radiology

  • High-dose single-session multipronged ethanol ablation can be used to treat early-stage or recurrent hepatocellular carcinoma up to 5.0 cm effectively and safely and may be applied even for lesions at high-risk locations.

Diagnosis Please

  • To reach the correct diagnosis of hereditary angioedema, it was necessary to integrate the patient's imaging findings with his clinical and family history, as well as his laboratory data; this case illustrates the necessity of the integration of clinical and radiologic findings, as well as the use of a pattern approach to complex small-bowel processes.

Departments

This Month in Radiology

Resources for Reviewers

    Help