RSNA 2011

By Tuesday February 21st, 2012News

RSNA – Radiological Society of North America has more than 48 000 members in 137 countries across the world. Every year the main event hosted by Chicago takes place on the last Sunday of November gathering more than 60 000 attendees – doctors, medical professionals, medical students, healthcare managers and exhibitors. It is considered to be the premier annual meeting for radiologists in the world. The event itself contributes more than $133 million to Chicago economy.

RSNA 2011 Facts and Figures

97th Scientific Assembly and Annual Meeting of Radiological Society of North America, November 27 – December 2 2011, was held in McCormick Place in Chicago, US. During these six days more than 60,000 radiologists, radiation oncologists, medical physicists, radiologic technologists, allied health care professionals and exhibitors attended the conference.

A staggering 1,831 scientific papers in 16 subspecialties,  refresher courses, 127 multisession courses, 2124 education exhibits and 1,188 scientific posters were available for participants. Apart from scientific presentations RSNA is also a place where companies operating on the healthcare market present their latest state-of-the-art technologies, new products and services. There were 685 technical exhibits occupying more than 4.3 hectares
(43k square meters) in three enormous exhibition halls.

Technical Exhibits

As usual Technical Exhibits were dominated mainly by very large expositions of the “Big Three” – General Electric, Philips and Siemens. This year Philips had the largest area among all participating companies with a very modern two-level exhibition. Most of the major world’s healthcare equipment manufacturers were present. There was a high  prevalence of medical software vendors offering new IT solutions for hospitals and clinics such as 3D radiological post processing software, HIS, RIS and PACS systems. An interesting new development was that there was an increasing technological shift towards cloud computing and “the world is my office” approach.

This year there were no spectacular premieres of breakthrough technologies. Most of the major manufacturers focused on improvements of their existing equipment and  development of software healthcare solutions. One worth mentioning was the first fully integrated PET-MRI scanner developed by Siemens. 3.0T fully functional MRI system was fused with a PET scanner allowing for simultaneous acquisition of whole body PET-MRI images without compromising the quality of scans. The manufacturer, however, admits that this 4 million Euro piece of equipment does not yet have significant advantage over classic PET-CT fusion, thus making this investment disputable.

Another interesting development that was clearly visible among vendors was the focus on patient experience. An interesting solution was presented by Philips called “Ambient Experience” which basically redesigns the MRI room both to be more functional and good looking as well as to be more patient friendly. There are many ergonomic solutions that make the workflow more efficient such as hidden storage for coils and convenient patient monitoring system. However, the most interesting feature allows patients to choose their theme, which instantly changes the music, lighting and displays images inside the  Faraday’s cage that make patients calm and relaxed. GE is also working on such a solution for their MRI systems.

Medical Update

Lectures and scientific panels were divided into 16  different subspecialties: breast; cardiac; chest; emergency radiology; gastrointestinal; genitourinary; health services, policy and research; informatics; molecular imaging; musculoskeletal; neuroradiology; nuclear medicine; pediatric; physics; radiation oncology and radiobiology; and vascular and interventional radiology. The main focus of this year’s RSNA meeting was placed on minimally invasive diagnostics (Cardiac CT, Breast Imaging) and interventions (invasive radiology), as well as molecular imaging.

Medical Highlights from RSNA 2011

“PET/MR. In Search of the Killer App” (Molecular Imaging Insight, Dec 5, Vol. 5, No. 4, 2011)

PET/MR emerged nearly a decade after PET/CT was first commercially available. The fusion of PET and MRI scanners into one system offering simultaneous acquisition will capitalize on strengths of each, providing a hybrid technology that is superior to the sum of its parts. Simultaneous acquisition will enable precise coregistration of anatomo-molecular information. The most significant use of the device will most probably be in  oncology (especially of CNS), cardiology and neurology.

Conclusions during RSNA 2011 sessions regarding PET/MR show that despite potential clinical advantages, high cost of the scanner (EUR 4 million) as well as scarce clinical data could prohibit many centres from adopting this technology in the nearest future.

“Low-Dose Molecular Breast Imaging. Is it finally here?” (Molecular Imaging Insight, Dec 5, Vol. 5, No. 4, 2011)

Mammography screening has been proven as an effective way to reduce mortality from breast cancer. Nevertheless, it shows lower sensitivity in women with dense breasts. Low dose molecular breast imaging (MBI) holds promise as cost efficient alternative for these patients. “About 80% of women at age 40 have dense tissue, and approximately 40% of women at age 80 have dense tissue” (prof. Michael K. O’Connor, Mayo Clinic). The main target group for MBI are high-risk women and women with recent diagnosis of breast cancer that do not qualify for MRI, and women in general population who have complex, dense mammogram, but do not qualify for MRI.

MBI is nuclear medicine technique that provides high-resolution, functional images using special gamma-cameras in mammographic configuration. This approach increased the sensitivity of detecting breast cancer by 7.5 per 1000 women screened. Current technology makes it possible to acquire diagnostic images with doses as low as 8mCi.

“Protein-based Molecular Imaging Technique Boosts MR Accuracy”

According to lecture presented by Dr. Guang Jia from The Ohio State University Medical Centres, a new MR imaging technique detects protein content at the cellular level and may improve assessment of cancer. Moreover, the intracellular mobile protein levels can be an early predictor of therapy responses, which could not be provided by current imaging approaches” (Dr Guang Jia).

The technique called Amide proton transfer (APT) MR imaging depicts disease related changes on a cellular level by analyzing phenomenon called magnetization transfer ratio (MTR) that results from amide protons in protein molecules rotating faster than free water. This corresponds with cellular mobile protein levels and can be used as a biomarker for active tumor. As tumors proliferate at a higher rate than healthy cells, they create a lot of proteins that can be detected by APT MRI. More available.

“Mechanistic Imaging Takes Neuroradiology to Next Level”

Mechanistic Imaging, also known as functional or molecular imaging, allows the visualization of pathophysiology – changes in function caused by the disease. This type of imaging is not only showing potential in neurology but increasingly in oncology and cardiology.

Apart from presenting clinical cases on how PET/MR helped solve difficult cases, Dr Gregory Sorensen from Siemens North America, also highlighted the functional imaging potential of 7.0T MRI systems in Alzheimer’s disease and cardiology. More available…

“Radiology Spurs Decade’s Greatest Alzheimer’s Advancements”

“Innovation in imaging technology and the development of new therapeutic agents are revolutionizing radiology’s role in diagnosing and caring for patients with Alzheimer’s disease (AD)” Dr Jeffrey R. Petrella, Duke University School of Medicine. Thanks to imaging modalities such as PET and MRI coupled with biomarkers from spinal fluid doctors are now able to diagnose AD at an earlier stage. Combining biomarkers and mechanistic imaging will be the future of diagnosing and developing cure for AD. More available…

“Physicians Challenged to Define the Clinical Benefit of Proton Therapy”

“Proton therapy can increase the therapeutic index of radiation treatments, specifically in pediatric malignancies and lung cancer, but isn’t without its limitations” said Dr Stephen M. Hahn and Prof. Henry K. Pancoast from University of Pennsylvania School of Medicine. Proton therapy reduces radiation dose to normal tissues as compared w th conventional treatment including IMRT. It also allows to deliver higher therapeutic dose more precisely in the tumor site, allowing for treatment of malignancies close to critical organs. Nevertheless, more clinical trials are needed to pinpoint the advantages of proton beam therapy over conventional radiotherapeutic techniques. More available…

“Diffusion-Tensor Imaging (DTI) Increasingly Essential in Musculoskeletal Disorders”

“While researchers have long used DTI to asses brain abnormalities, recent studies suggest the method is also a powerful tool inmusculoskeletal imaging” said Dr. Jean Francois Budzik from Hopital Roger Salengro in Lille, France. This imaging technique that has proven itself in brain imaging has been also found useful in diagnosing compressed lumbar nerves, carpal tunnel syndrome, neural tumours, and cervical spondylotic myelopathy. DTI could lead to earlier diagnosis of pathologies affecting the peripheral nerves or the muscles.

Today treatment decisions are mainly based on clinical symptoms as these pathologies are sometimes difficult to spot on the standard MR scan. By adding the DTI information we could help those patients who complain of pain or exhibit other disease symptoms but come out with a “normal” MRI report. More available…