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This Month In Radiology December
 

This Month In Radiology December

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I write "This Month in Radiology", the monthly synopses of featured articles appearing in the peer-reviewed journal Radiology.

I write "This Month in Radiology", the monthly synopses of featured articles appearing in the peer-reviewed journal Radiology.

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    This Month In Radiology December This Month In Radiology December Document Transcript

    • Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article. DEPARTMENTS ■ This Month in Radiology ©RSNA, 2008 Sparse Prostate Tumors Indistinguishable by Using T2, ADC Apparent diffusion coefficient (ADC) and T2 values at MR examinations may not iden- tify sparse areas of prostate cancer. Langer and colleagues studied 18 patients with 28 peripheral zone prostate tumors. The researchers found that while dense tumors had significantly lower ADC and T2 values than normal peripheral regions, there was no significant difference between sparse tumors—which contain a high percent- age of normal tissue—and surrounding normal regions. The researchers warn that the presence of regions within prostate tumors that are intrinsically invisible by us- ing T2- and ADC-based tissue contrast may hinder accurate focal therapy. ❚ Page 900 Tomosynthesis Outperforms Radiography in Pulmonary Nodule Detection Chest tomosynthesis is significantly better than chest radiography at depict- ing pulmonary nodules. Vikgren and colleagues found in a study of 89 patients that the number of lesion localizations relative to the total number of lesions was three times higher for tomosynthesis and the number of nonlesion localizations rela- tive to the total number of cases was approximately 50% higher for tomosynthesis than radiography. The sensitivity of tomosynthesis was especially increased for nod- ules smaller than 9 mm. The researchers proposed that while the depth resolution in tomosynthesis is lower than that of CT, it is far superior to radiography, and its low radiation dose makes it an interesting alternative in chest radiology. ❚ Page 1034 MR Depicts Small Myocardial Lesions MR imaging can depict small multifocal areas of myocardial damage. In an animal study of 18 minipigs in which coronary microembolization was performed, Nassenstein and col- leagues found that myocardial lesions appeared as blurred areas of moderately increased signal intensity in vivo. Damage exceeding 5% of myocardium within the region of interest was necessary to detect late gadolinium enhancement in vivo, and high-spatial-resolution imaging with high signal-to-noise and contrast-to-noise ratios allowed more detailed char- acterization of lesions, the researchers found. They advised that the color gray, repre- senting intermediate signal intensity, is important in patients with nonischemic disease, because it may result from a mixture of damaged and normal myocardium. ❚ Page 829 On-Call Residents Provide Relatively Accurate MR Interpretation Discrepancy rates in neuroradiologic MR interpretation by residents on call are low and do not result in significant adverse clinical outcomes. Comparing residents’ pre- liminary interpretations of 361 emergent brain and spine MR and MR angiographic examinations to the final reports of attending radiologists, Filippi and colleagues found an overall agreement rate of 92.8%. While misinterpretations among 1st-year residents were significantly greater than among more senior-level residents, major discrepancies— those that could affect patient care or clinical outcome—were low and comparable with reported error rates for head CT interpretation. Discrepancies between 1st-year and senior residents will likely be mitigated by recent changes recommending resident call deferral until the 2nd year of training, as determined by the researchers. ❚ Page 972 3A Radiology: Volume 249: Number 3—December 2008
    • ■ CONTINUED THIS MONTH IN RADIOLOGY Upper Extremity CT Accurate for Assessing Penetrating Trauma CT angiography can help direct treatment in patients with penetrating trauma to the up- per extremities. In a study of 59 patients, Anderson and colleagues found that, in con- junction with clinical assessment, upper extremity multidetector CT angiography helped detect acute vascular injuries and allowed 88% of patients to undergo conservative treat- ment with no complications at follow-up. The researchers concluded that with appropriate patient selection, optimized CT protocols, and experienced clinicians, upper extremity CT angiograms are technically accurate for assessing penetrating trauma. ❚ Page 1064 Intravoxel Incoherent Motion DW Imaging Demonstrates Restricted Diffusion and Perfusion-related Parameters in Liver Cirrhosis An MR imaging sequence based on the intravoxel incoherent motion (IVIM) theory may have applications in liver cirrhosis. Using IVIM diffusion-weighted (DW) imag- ing that combined parallel and respiratory-triggered acquisition in a study of 37 pa- tients, Luciani and colleagues observed restricted global diffusion with decreased apparent diffusion coefficient in liver cirrhosis. The researchers proposed that re- stricted diffusion could be explained in part by perfusion-related diffusion param- eters within the liver parenchyma. IVIM DW imaging enables the extraction of diffu- sion parameters reflecting microcirculation, or perfusion, which could potentially be used as surrogate markers for liver cirrhosis, the researchers concluded. ❚ Page 891 An editorial by LeBihan accompanies this article (p 748). Flat-Panel Volume CT Demonstrates Effects of Anorexia Nervosa on Bone Structure Flat-panel volume CT reveals that bone structure in adolescent girls with anorexia nervosa (AN) is abnormal despite normal bone mineral density. In a study of 10 ad- olescent girls with mild AN and 10 normal-weight control subjects, Bredella and col- leagues found that flat-panel volume CT effectively depicted trabecular microarchi- tecture and demonstrated bone structure deficiencies in girls with AN, even when bone mineral density at dual-energy x-ray absorptiometry was normal. Flat-panel vol- ume CT depicts abnormalities even in mild or early disease, the researchers ob- served, and may have major implications in treatment and follow-up. ❚ Page 938 MR Techniques Identify Viable Myocardium after Chronic Myocardial Infarction In patients with chronic myocardial infarction, reduced perfusion in the infarct zone as detected at MR is related to the extent of viable myocardium. In a study of 29 patients who underwent first-pass contrast-enhanced MR and delayed-enhancement MR at least 6 months after onset of infarction, Su and colleagues found that remaining viable myocardium demonstrated increased perfusion during stress tests and presented similarly to remote myocardium. The researchers concluded that the combination of MR techniques can estimate the extent of scar tissue, regional perfusion, and myocardial perfusion reserve in chronically infarcted myocardium. ❚ Page 820 3D Isotropic MRCP Highly Sensitive for Biliary Disease MR cholangiopancreatography (MRCP) using a respiratory-triggered isotropic 3D fast-recov- ery fast spin-echo sequence with parallel imaging is excellent for diagnosing biliary disease. In a study of 95 patients suspected of having biliary disease, Nandalur and colleagues found that MRCP was highly sensitive and specific for strictures, dilatation, and intraductal filling defects, but yielded sensitivity of 33%--42% for stones 3 mm or smaller. The researchers proposed that the high spatial resolution and relatively short acquisition times of the MRCP technique make it feasible for diagnosing strictures, dilatation, and stones larger than 3 mm. ❚ Page 883 Ethnic Differences Influence Screening Mammography Behavior Differences in ethnic background influence women’s preferences for screening mammog- raphy recall, desire for early detection, and adherence to annual screening mammog- raphy once given a false-positive result. In a study of 911 women in an underserved, predominantly minority population, Jafri and colleagues found that black and Hispan- ic women were significantly less likely than were white women to continue with future screening after a false-positive result and were also more reluctant to return for both noninvasive and invasive studies with a higher possibility of cancer detection. Targeted education is needed to address cultural barriers to screening mammography and improve breast cancer prognoses among minority women, the researchers concluded. ❚ Page 785 Radiology: Volume 249: Number 3—December 2008 4A
    • Radiology 2008 This is your reprint order form or pro forma invoice (Please keep a copy of this document for your records.) Reprint order forms and purchase orders or prepayments must be received 72 hours after receipt of form either by mail or by fax at 410-820-9765. It is the policy of Cadmus Reprints to issue one invoice per order. Please print clearly. Author Name _______________________________________________________________________________________________ Title of Article _______________________________________________________________________________________________ Issue of Journal_______________________________ Reprint # _____________ Publication Date ________________ Number of Pages_______________________________ KB # _____________ Symbol Radiology Color in Article? Yes / No (Please Circle) Please include the journal name and reprint number or manuscript number on your purchase order or other correspondence. Order and Shipping Information Reprint Costs (Please see page 2 of 2 for reprint costs/fees.) Shipping Address (cannot ship to a P.O. Box) Please Print Clearly Name ___________________________________________ ________ Number of reprints ordered $_________ Institution _________________________________________ Street ___________________________________________ ________ Number of color reprints ordered $_________ City ____________________ State _____ Zip ___________ ________ Number of covers ordered $_________ Country ___________________________________________ Subtotal $_________ Quantity___________________ Fax ___________________ Taxes $_________ Phone: Day _________________ Evening _______________ E-mail Address _____________________________________ (Add appropriate sales tax for Virginia, Maryland, Pennsylvania, and the District of Columbia or Canadian GST to the reprints if your order is to Additional Shipping Address* (cannot ship to a P.O. Box) be shipped to these locations.) Name ___________________________________________ Institution _________________________________________ First address included, add $32 for Street ___________________________________________ each additional shipping address $_________ City ________________ State ______ Zip ___________ Country _________________________________________ Quantity __________________ Fax __________________ TOTAL $_________ Phone: Day ________________ Evening ______________ E-mail Address ____________________________________ * Add $32 for each additional shipping address Payment and Credit Card Details Invoice or Credit Card Information Please Print Clearly Invoice Address Enclosed: Personal Check ___________ Please complete Invoice address as it appears on credit card statement Credit Card Payment Details _________ Name ____________________________________________ Checks must be paid in U.S. dollars and drawn on a U.S. Bank. Institution ________________________________________ Credit Card: __ VISA __ Am. Exp. __ MasterCard Department _______________________________________ Card Number __________________________________ Street ____________________________________________ Expiration Date_________________________________ City ________________________ State _____ Zip _______ Country ___________________________________________ Signature: _____________________________________ Phone _____________________ Fax _________________ Please send your order form and prepayment made payable to: E-mail Address _____________________________________ Cadmus Reprints P.O. Box 751903 Cadmus will process credit cards and Cadmus Journal Services will appear on the credit card statement. Charlotte, NC 28275-1903 Note: Do not send express packages to this location, PO Box. If you don’t mail your order form, you may fax it to 410-820-9765 with FEIN #:541274108 your credit card information. Signature __________________________________________ Date _______________________________________ Signature is required. By signing this form, the author agrees to accept the responsibility for the payment of reprints and/or all charges described in this document. RB-9/26/07 Page 1 of 2
    • Radiology 2008 Black and White Reprint Prices Color Reprint Prices Domestic (USA only) Domestic (USA only) # of # of 50 100 200 300 400 500 50 100 200 300 400 500 Pages Pages $221 $233 $268 $285 $303 $323 $223 $239 $352 $473 $597 $719 1-4 1-4 $355 $382 $432 $466 $510 $544 $349 $401 $601 $849 $1,099 $1,349 5-8 5-8 $466 $513 $595 $652 $714 $775 $486 $517 $852 $1,232 $1,609 $1,992 9-12 9-12 $576 $640 $749 $830 $912 $995 $615 $651 $1,105 $1,609 $2,117 $2,624 13-16 13-16 $694 $775 $906 $1,017 $1,117 $1,220 $759 $787 $1,357 $1,997 $2,626 $3,260 17-20 17-20 $809 $906 $1,071 $1,200 $1,321 $1,471 $897 $924 $1,611 $2,376 $3,135 $3,905 21-24 21-24 $928 $1,041 $1,242 $1,390 $1,544 $1,688 $1,033 $1,071 $1,873 $2,757 $3,650 $4,536 25-28 25-28 $1,042 $1,178 $1,403 $1,568 $1,751 $1,924 $1,175 $1,208 $2,122 $3,138 $4,162 $5,180 29-32 29-32 $97 $118 $215 $323 $442 $555 $97 $118 $215 $323 $442 $555 Covers Covers International (includes Canada and Mexico) International (includes Canada and Mexico)) # of # of 50 100 200 300 400 500 50 100 200 300 400 500 Pages Pages $272 $283 $340 $397 $446 $506 $278 $290 $424 $586 $741 $904 1-4 1-4 $428 $455 $576 $675 $784 $884 $429 $472 $746 $1,058 $1,374 $1,690 5-8 5-8 $580 $626 $805 $964 $1,115 $1,278 $604 $629 $1,061 $1,545 $2,011 $2,494 9-12 9-12 $724 $786 $1,023 $1,232 $1,445 $1,652 $766 $797 $1,378 $2,013 $2,647 $3,280 13-16 13-16 $878 $958 $1,246 $1,520 $1,774 $2,030 $945 $972 $1,698 $2,499 $3,282 $4,069 17-20 17-20 $1,022 $1,119 $1,474 $1,795 $2,108 $2,426 $1,110 $1,139 $2,015 $2,970 $3,921 $4,873 21-24 21-24 $1,176 $1,291 $1,700 $2,070 $2,450 $2,813 $1,290 $1,321 $2,333 $3,437 $4,556 $5,661 25-28 25-28 $1,316 $1,452 $1,936 $2,355 $2,784 $3,209 $1,455 $1,482 $2,652 $3,924 $5,193 $6,462 29-32 29-32 $156 $176 $335 $525 $716 $905 $156 $176 $335 $525 $716 $905 Covers Covers Tax Due Minimum order is 50 copies. For orders larger than 500 copies, Residents of Virginia, Maryland, Pennsylvania, and the District please consult Cadmus Reprints at 800-407-9190. of Columbia are required to add the appropriate sales tax to each reprint order. For orders shipped to Canada, please add 7% Reprint Cover Canadian GST unless exemption is claimed. Cover prices are listed above. The cover will include the publication title, article title, and author name in black. Ordering Reprint order forms and purchase order or prepayment is Shipping required to process your order. Please reference journal name and reprint number or manuscript number on any Shipping costs are included in the reprint prices. Domestic correspondence. You may use the reverse side of this form as a orders are shipped via UPS Ground service. Foreign orders are proforma invoice. Please return your order form and shipped via a proof of delivery air service. prepayment to: Multiple Shipments Cadmus Reprints Orders can be shipped to more than one location. Please be P.O. Box 751903 aware that it will cost $32 for each additional location. Charlotte, NC 28275-1903 Delivery Note: Do not send express packages to this location, PO Box. Your order will be shipped within 2 weeks of the journal print FEIN #:541274108 date. Allow extra time for delivery. Reprint Order Forms Please direct all inquiries to: and purchase order Rose A. Baynard or prepayments must 800-407-9190 (toll free number) be received 72 hours 410-819-3966 (direct number) after receipt of form. 410-820-9765 (FAX number) baynardr@cadmus.com (e-mail) Page 2 of 2