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Current Edition

December 2016

Volume 1  Issue 1

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Editorial

Managing Patients and Resources in Nuclear Radiology

Eduardo Pérez*

Healthcare costs in the U.S. have increased rapidly in recent years and now exceed those in other nations that provide equivalent or better care. Increased demand for specialized services has been identified as one of the causes of this trend in U.S. healthcare costs. Machine time, direct labor time, and radiopharmaceuticals contribute the most to the total cost of each procedure in nuclear radiology. The way these resources are managed has a direct impact in the overall cost and the quality of service to the patient. Increased demand for nuclear radiology procedures coupled with the complexity of the procedures, make managing patient service and resources very challenging.

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Editorial

Functional mitral regurgitation in patients with coronary artery disease: Ischemic or Necrotic?

Jesus Peteiro, MD, PhD*

Functional (also called ischemic) mitral regurgitation (MR) in patients with coronary artery disease (CAD) is a disease of the cardiac muscle instead of a disease of the valve. This MR is produced by left ventricular (LV) global remodeling (dilation and sphericity) or regional remodeling in either case leading to tethering of the valvular apparatus towards a dyssinergic wall. This tethering may lead to restriction of the leaflets and incomplete closure of the valves in systole (Figure 1). Both valve closing force decrease due to LV systolic dysfunction and dyssynchrony may also have a role. This entity has been comprehensively studied in recent years with both resting and exercise echocardiography studies.

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Editorial

Arterial Spin Labeling :fMRI Is It Ready For Functional Connectivity?

Xiaoyun Liang*, Chun-Hung Yeh

Arterial spin labeling (ASL) measures cerebral blood flow (CBF) noninvasively and it therefore directly correlates neural activity. As an alternative to BOLD fMRI, ASL fMRI has attracted increasingly interest in neuroimaging, of which functional connectivity is the main focus. While it was struggling to conduct functional connectivity using ASL before, this situation has been changed upon the recent development of advanced techniques. Studies have shown that pCASL combined with 3D GRASE sequence is capable of detecting functional brain networks. This suggests that up-to-date ASL technique is ready for investigating functional connectivity.

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Editorial

The Feasibility of Quantifying White Matter Connectivity Using Diffusion MRI

Chun-Hung Yeh*, Xiaoyun Liang

Diffusion MRI is a unique technique for non-invasively probing structural connectivity of human brains. However, quantitative estimate of white matter fibre connectivity based on diffusion MRI is not feasible due to the bias produced systematically in the process of streamlines tractogram reconstruction. SIFT (Spherical-deconvolution informed filtering of tractograms) is a newly developed methodology to tackle this issue and to provide robust and accurate quantification of structural connectivity. This should be particularly beneficial for brain research that aims to characterise and compare structural connectome of human brains.

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Editorial

Quantitative PET/MRI Evaluation and Application in Dementia

Yongxia Zhou, PhD*

A recently introduced integrated scanner combining simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) (PET/MRI) acquisition presents a unique set of opportunities for neuroimaging research and dementia in particular. Among these, the intrinsic co-registration of the images has the potential to reduce errors in multi-modality image registration, which could lead to better quantification of longitudinal volumetric changes in neuroanatomical features that are important for assessing disease progression. PET tracers could provide functional information of brain biochemical processes by radio-labeling specific molecular with high sensitivity and specificity, while MRI could provide superior structural information.

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Case Presentation

Tropical Pyomyositis Diagnosis by a Modern Medical Imaging - A Case Report and Review Of Literature

L B Samarakoon*, P Piranavan, K S Perera

Tropical pyomyositis is characterized by single or multiple abscesses within the large skeletal muscle groups of the body. Although initially described in the tropics, an increasing number of cases have been reported from the temperate climates. Although fever and myalgia is a common presenting feature, Topical pyomyositis can be a great masquerader, mimicking a wide variety of commoner diseases, making it a diagnostic challenge to the less experienced or the unsuspecting clinician.

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Research Article

New Automatic Slice-Alignment Method for Cardiac Magnetic Resonance Imaging -Clinical evaluation with a 1.5T scanner-

Kenichi Yokoyama*, Rieko Ishimura, Masamichi Imai, Toshiya Kariyasu, Toshiaki Nitatori, Shigehide Kuhara, Shuhei Nitta, Tomoyuki Takeguchi, Nobuyuki Matsumoto

Cardiac magnetic resonance (CMR) imaging is an excellent tool for obtaining accurate morphological and functional measurements of the heart, which are essential for diagnosis, prognosis, and therapeutic decision-making in the clinical setting. The precise morphological characterization of cardiac structures requires complex procedures for acquiring the necessary scout scans to obtain suitable views in a minimal amount of time. In conventional CMR examinations, anchoring of the heart is typically performed using a multistep approach involving the acquisition of double-oblique views in order to determine the long and short axes of the heart.

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Research Article

CT Classification of Ureteral Calculi Parameters for Predicting Ureteroscopy Complications

Nathan Edward Hale*, Samuel Deem, Joshua Lohri

Unenhanced computed tomographic (CT) scan is the imaging of choice for the diagnosis of urolithiasis with reported sensitivity and specificity approaching 100%.The two most important factors that guide clinical management are stone size and its location. Precise interpretation of the CT scan is crucial while counseling the patient and selecting the appropriate treatment strategy. Ureteroscopy (URS) has been used for treatment of ureteral calculi since the late  1970’s. Improvements in equipment and surgeon skill haveimproved both the safety of URS and its frequency of use.

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Research Article

Monitoring Diagnosis and Treatment of Infectious Spondylodiscitis

Onur ÖZGENÇ*, Berna BOZCA, Meltem AVCI, Gülşen MERMUT, Melis DEMİRCİ, Vecdi Evren GENÇ, Seher Ayten COŞKUNER

The objective of this study was to describe the more consistent findings of pyogenic, brucellar, and tuberculous spondylodiscitis and to improve the early diagnosis and treatment strategies of infectious spondylodiscitis. The etiological distinction of 72 patients was made on the basis of clinical and routine laboratory evaluation, microbiological, histopathological and radiological grounds. The diagnosis of infectious spondylodiscitis was performed by imaging techniques. The patients were diagnosed as tuberculous (28%), brucellar (54%), and pyogenic (18%) spondylodiscitis. The mean age of the patients were 54.7±13.9 years, being 53% as female, and 47% as male.

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Editorial

Electromagnetic Radiation-Based Imaging Modalities May be Associated with Increased Release of Mercury from Dental Amalgam Fillings

Ghazal Mortazavi, Maryam Paknahad, SMJ Mortazavi*

Radiography and MRI are among the most efficient widely used diagnostic imaging modalities. It is now well documented that mercury even at low doses may lead to toxicity. We have previously shown that exposure to MRI or electromagnetic fields emitted by mobile phones can increase the release of mercury from dental amalgam fillings. X-ray exposure has also been linked to increased mercury release from dental amalgam fillings. Although, the increased levels found in our studies normally cannot led to toxicity, it may be a significant health risk in specific subpopulations such as pregnant women, children, people with hypersensitivity to mercury or individuals whom are rountiely exposed to above-the-background levels of electromagnetic fields (e.g. power line or radar workers).

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Interesting Image

Lymphomatous Involvement of the Kidneys in Mantle Cell Lymphoma

Carina Mari Aparici, Tianye Liu* and Gerald Hsu

Mantle cell lymphoma rarely shows kidney involvement. We report the case of a 41 year-old man diagnosed with stage IV mantle cell lymphoma. Staging FDG PET/CT showed mild FDG activity in enlarged lymph nodes on both sides of the diaphragm as well as remarkably enlarged bilateral kidneys, with mild diffuse FDG activity in the renal cortex. After chemotherapy, the sizes of the kidneys and lymphadenopathy dramatically decreased. We recommend careful assessment of kidney involvement in patients with lymphoma during staging/surveillance with FDG-PET/CT.       
 

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Research Article

Results of a Novel and Comprehensive Training Program for Standardization of 2 -Dimensional Ultrasound Interpretation as a Precursor to a Multicenter Trial

Mueller ER*, Corton M, Fielding J, Spino C, Jelovsek JE, Weidner A, Zyczynski H, Menefee S, Gantz MG, Tuteja A, and Richter HE for the Pelvic Floor Disorders Network

Assuring the accuracy of outcome data from diagnostic tests is a universal challenge in multicenter clinical trials. This can increase in complexity when diagnostic tests are being performed by different clinical specialties. That said, participation of qualified multi-disciplinary investigators might improve the validity and generalizability of the study conclusions. The design of a process to standardize test performance and accuracy of interpretation is just as crucial to the success of a research study as is recruitment of subjects, since the validity of the test findings depend upon training investigators to consistently perform and interpret the test in a standardized manner.     

   

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Case Report with Review of Literature

Mesenteric Venous Thrombosis Complicated by Heparin Induced Thrombocytopenia

Gamal H El Shallaly*, Haifa O Al-Otaibi

Acute mesenteric venous thrombosis (MVT) is a rare cause of adynamic intestinal obstruction (paralytic ileus) that is associated with high mortality. A high index of suspicion is required to diagnose this condition. Contrast-enhanced CT scan is diagnostic. Management is usually complex and requires multidisciplinary approach, because MVT usually occurs in older patients with co-morbid disorders. Moreover, Heparin induced thrombocytopenia (HIT) can complicate heparin therapy which is the mainstay of medical management.     

   

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Research Article

A Tissue-Equivalent Phantom for the X-ray Evaluation of Polymeric Orthopedic Implants with Osseointegrative Coating

Francesco Tessarolo*, Nicola Pace, Gloria Miori, Giandomenico Nollo, Mauro Recla, Aldo Valentini

Orthopaedics polymeric implants made of ultra-high molecular-weight polyethylene (UHMWPE), polyether-ether-ketone (PEEK) or its carbon-fiber reinforced composite (CFR-PEEK) can be coated with titanium (Ti) or hydroxyapatite (HA) by compression- moulding or plasma-spray techniques for bone integration. The coating may also improve the radiological properties of the implanted device. This work aimed at developing a tissue-equivalent phantom for measuring the radiological contrast given by different polymeric materials coated with Ti or HA for orthopedic implant applications.     

   

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