John Hopkins researchers have shown that non-invasive CT angiograms are more effective at detecting clogged coronary arteries than exercise stress tests. Around 15 million Americans visit physicians each year with symptoms of a clogged artery. Chest pain, shortness of breath and fatigue often warrant further testing to spot any blockages. Cardiologists typically rely on a stress test that measures blood flow after a patient walks on a treadmill. American Heart Association guidelines currently call for this test when patients show signs of coronary artery disease. The new study indicates that CT angiograms may be a better testing method due to lower radiation levels, higher accuracy and comparable cost.

The gold standard for detecting clogged arteries remains an invasive cardiac angiography. This test involves threading a catheter into a patient’s heart blood vessels. It’s a process that carries certain risks, so cardiologists utilize an initial “gatekeeper” test to identify the people most likely to benefit from it. The John Hopkins study shows that stress tests only correctly identify blockages in 6 out of 10 people. Comparatively, CT scans accurately spotted blockages in 9 out of 10 patients.

Participants of the study underwent all three testing methods, providing a direct comparison of the effectiveness of each. For CT angiograms, clinicians inject dye into a patient’s circulation to visualize the arteries. The test spots blockages caused by fatty buildups or clots in the interior of arteries. Clinicians have shied away from this process in the past due to limited evidence of its efficacy. The recent study examined 391 patients in 16 hospitals and eight countries. It was the largest study of its kind to date.

The researchers hope that the results show clinicians that CT angiograms are a more accurate alternative than the widely used stress tests. Both tests provide a first-line diagnosis before an invasive cardiac angiography. The unprecedented scale of the study gives cardiologists solid evidence to support CT scanning. For patients concerned about blocked arteries, the results are promising. A near-perfect diagnosis rate seems more realistic than ever before.

 

A recent study has found evidence that a shorter noncontrast-enhanced breast MRI protocol could reduce scanning times and improve information gathering for suspicious lesions. The study was performed by the German Cancer Research Center and led by Dr. Sebastian Bickelhaupt. The protocol, referred to as diffusion-weighted imaging with background suppression (DWIBS), had a negative predictive value of 92%, comparable to conventional diagnostic MRIs. The DWIBS method was able to obtain images in just seven minutes vs. 30 minutes for the standard protocol. The approach may increase the rate of positive biopsies.

MRI exams are often used to complement conventional mammography, which has a high false-positive rate. Traditional MRI exams use contrast and can be time-consuming. The authors were interested in abbreviated exams due to recent papers demonstrating the benefits of such an approach. They compared this method with an abbreviated contrast-enhanced protocol as well as a full diagnostic breast MRI.

The study took place between September 2014 and January 2015. The researchers enrolled 50 women who had suspicious screening mammogram results and an indication for biopsy. They performed the exams on a 1.5-tesla scanner. The study was performed between two imaging sites with two readers blinded to the each other’s data and interpretations.

The DWIBS method came out positive for 100% of the histopathologically confirmed invasive breast cancers among the test group. The only exceptions were two lesions with pure microcalcifications. The authors noted that these are “notoriously invisible” when using MRI. There was no significant difference between the accuracy of full diagnostic and the abbreviated protocols.

The study had some limitations, such as a patient group with a greater probability of malignant lesions than an unselected population, which the researchers acknowledged. The team concluded that the DWIBS mammography protocol was accurate in ruling out malignancy after an initial mammogram screening.

A recent study published in PLOS One shines light on the efficacy of various medical image processing techniques used to evaluate tumors of the trachea and bronchus. Researchers from China and the U.S. examined 31 patients with primary trachea and bronchus tumors. They used multiplanar reformatting, volume rendering and virtual bronchoscopy image processing techniques and evaluated the advantages and disadvantages of each.

The researchers examined factors such as tumor locating accuracy, morphology, extramural invasion and the extent of luminal stenosis. None of the techniques had perfect accuracy analyzing tumors. It was determined that the effectiveness of each depends on the situation. According to lead author Mingyue Luo from Sun Yat-sen University, the three methods may work best together.

Primary trachea and main bronchus tumors have very distinct features as a result of different growth modes and development directions. The authors examined endoluminal nodular tumors with both wide and narrow bases as well as intraluminal and extraluminal tumors. They noted that advanced image reconstructing techniques can provide more anatomically and diagnostically useful information than traditional CT. The results were consistent with those of surgery and pathology.

Each technique was found to have its own benefits for tumor detection and evaluation. Multiplanar reformatting separates tissue densities without any obvious artifacts. It is able to measures the distances between main bronchus tumors and trachea carinae. Volume rendering creates well-differentiated displays with good contrast resolution. It can maintain data on spatial relationships and produce 3D effects. Virtual bronchoscopy allows 3D visualization of trachea and main bronchus walls. It can display a tumor’s surface morphologies and proximal regions, according to Luo and colleagues.

Combining these three techniques may help to identify locations, natures and quantities of trachea and bronchus tumors. This approach can provide a wealth of essential information for surgical treatment.

 

On our teleradiology blog, we like to regularly post articles on findings that have been discovered in the medical field, especially when they relate to key areas of our business.

With that in mind, we found the following study on the possibilities for MRI brain interpretations fascinating, and we look forward to following any developments in the future. Give this Specialty Teleradiology summation on MRI brain scans a look.

MRI Brain Interpretations and Their Role in Stroke Prediction

According to a recent study published in the Annals of Internal Medicine it was reported that patients with one or two small lesions were five times more likely to have a stroke and/or have a stroke-related death. Researchers from the University of Mississippi Medical Center, along with a few other U.S. institutions, conducted the study.

Here are some of the key highlights about the conduction of the study:

• Researchers examined data from 1,884 patients from Forsyth County, North Carolina, and Jackson, Mississippi, who had previously participated in the Atherosclerosis Risk in Communities (ARIC) study.

• Patients “received scans on a 1.5-tesla MRI system with an imaging protocol that included T1-weighted, T2-weighted, and proton density-weighted imaging of the whole brain.”

• The data showed that the hazard ratio of stroke-related death for patients with any sized lesion was 6.97, compared to the hazard ration of 1.89 for all-cause death patients.

As one of the first studies to examine such data, the results have indicated the importance of further examination of similar situations. Small lesions could also indicate a future risk for other cerebrovascular diseases, such as dementia and other mobility problems. As medical imaging such as MRI brain interpretation becomes more sophisticated, we can potentially understand the causes and/or risks of 3 mm lesions and what they could mean for visibly asymptomatic patients with brain MRIs.

Further Industry Insights

We cover a lot of material on our blog, featuring information about regional imaging centers, useful media resources, historical perspectives on procedures, and more. Here are a few select posts to help you discover more about the radiology field:

• 3 MRI Spine Interpretation Trends to Know About
• Virtual Reality: Continuing to Shape Radiology and the Medical Field
• 5 Things to Consider When Choosing a Radiology Partner for Your Practice
• Why the “Human Aspect” Is So Essential to the Radiology Field
• 7 Reasons Why Partnering with a Teleradiology Professional Will Help Your Private Practice
• Women and Radiology: Working Toward a More Female-Populated Industry
• How Prostate Cancer MRIs Make Biopsies Unnecessary

You can additionally subscribe to our newsletter to get monthly updates from us.

Contact Us

Interested in our teleradiology services like MRI brain interpretations? Contact our team today!

In an effort to improve treatment for skeletal metastatic cancer – the most deadly form of the cancer – the Spanish Back Pain Research Network, Kovacs Foundation, conducted a study to see correlation between the Tomita and modified Bauer scores when determining the prognosis and surgical strategy. The goal of the study was to establish a standardized method of communicating the severity of metastatic spine disease through medical oncologists, radiologists, radiation oncologists, orthopedic surgeons, and neurosurgeons.

Eighty-three doctors with multiple levels of post-residency practice, specialties, and hospital complexity participated in the study and the first 90 patients that met the inclusion criteria and did not meet any of the exclusion criteria were accepted as subject participants. Intraobserver and interobserver variability were taken into account amongst the clinicians. Patient information was limited to two (2) MRIs and a clinical vignette of basic patient history and treatment.

Both intra- and inter-observer agreements were almost entirely “almost perfect” and “substantial.” This high agreement correlation could improve the efficiency and efficacy of treatment for patients with metastatic spine diseases. Previous studies have examined the benefits one scoring system over the other, but this is one of the first studies to utilize both scores for a better inter-disciplinary communication system. Future studies may have a more specific group of doctors, particular cancer subtypes and/or location of metastases, or hospital categories to further determine the best scenarios for interobserver communication.