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Radiology Plays Greatest Role to Date at the Olympics
Never in the history of the Olympics has diagnostic imaging played such a huge role. For the first time ever all four modalities–digital radiography, ultrasound, CT, and MRI–are represented...
Molecular imaging technique uses ultrasound and microscopic bubbles to target cancer cells...
American Stroke Association (ASA): Ultrasound Speeds Drainage of Brain Hemorrhages
Sonothrombolysis, a technique that combines ultrasound pulses and injection of a thrombolytic directly into a hemorrhage, appears safe and may be effective for treating hemorrhages in the brain...
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Radiology Plays Greatest Role to Date at the Olympics
Never in the history of the Olympics has diagnostic imaging played such a huge role. For the first time ever all four modalities–digital radiography, ultrasound, CT, and MRI–are represented...
Never in the history of the Olympics has diagnostic imaging played such a huge role. For the first time ever at the Winter Olympic games taking place in Vancouver, Canada, all four modalities–digital radiography, ultrasound, CT, and MRI–are represented in both the Alpine and city settings.
Another first for the Olympic Games is the addition of portable ultrasound units at, or near, the field of play.
The Olympic diagnostic imaging equipment is situated in the athletes’ villages in Vancouver and Whistler at what’s called a poly clinic, according to Dr. Bruce Forster, a professor at the University of British Columbia, Vancouver, and the Vancouver Organizing Committee imaging supervisor.
Poly clinic is an Olympics term that refers to a clinic that provides all medical services to athletes and Olympic families, which means everything from physiotherapy to imaging to lab to consultation by sports medicine physicians, he said.
In a first, each poly clinic has a 1.5T MRI, a 16-slice CT, a digital radiography machine, and an ultrasound machine, all provided by GE, a platinum global sponsor.
Another first is the use of portable ultrasound machines the size of a laptop in five venues outside the villages. The venues are Cyprus Mountain, where snowboard, cross country and freestyle skiing competitions are held, Canada Hockey Place where men’s hockey is played, UBC Thunderbird Arena, another hockey rink, Richmond Olympic Oval the site for long track speed skating.
The idea is to bring imaging to the athlete instead of vice versa, and allow coaches and National Olympic Committee physicians to have the most data they can to determine whether an injured athlete can return to the field of play, Forster said.
“For example, if you’re a women’s hockey player, and you’re playing at UBC rink and you strain a calf muscle in the first period, we can image you in between periods and help the coaches be able to decide whether you can go back,” he said.
The units are staffed by musculoskeletal (MSK) sonographers and the images are then sent via an extensive network to the poly clinics where the radiologists interpret them and give immediate feedback to the physician, according to Forster.
At the games there are 19 radiologists and 51 technologists, all Canadian. The host country picks the physicians and historically they all come from the host country. In Vancouver the individuals are all volunteers who work 13 shifts each, with a shift lasting about 8 hours. While the poly clinic is open from 7 a.m. to 11 p.m., a patient can come in at any time and still get imaged. Radiologists are on call, Forster said.
Generally speaking, the radiologists are all MSK-fellowship trained, but as there is only one radiologist at each poly clinic, it’s important to have diverse skills and be able to cover the unexpected imaging finding, Forster said.
“For instance if you’re an MSK radiologist, we need to have one of the two radiologists able to read head CTs, and acute trauma, or acute spine trauma CTs,” he said. “We had to make sure when selecting the team the radiologists could manage that diverse set of requirements.”
To volunteer for the Olympic Games there is an application process that asks questions such as their experience in MSK radiology and what sort of modalities the radiologist covers. There also is a security and accreditation check.
But just because the radiologists are at the Olympics doesn’t mean they get to go to games for free, Forster said.
“Everyone sees themselves at the gold medal hockey game, but the volunteers are told very early on there will not be a chance to go to any of the events for free,” he said. “I bought tickets just like everybody else.”
On the other hand, the radiologists and technologists do get to eat in same dining hall as the athletes and attend concerts in the athletes’ village.
“We eat at the same hall but there is still a divider between us and them,” Forster said. “It’s important that we don’t distract athletes. Usually any interaction is operational.”
Article written by staff at diagnosticimaging.com and adapted for the purposes of this newsletter.
Imaging Technique Combining Ultrasound and Microscopic Bubbles Help Visualize Tumor Activity at Molecular Level
Molecular imaging technique uses ultrasound and microscopic bubbles to target cancer cells...
An imaging technique combining ultrasound and specially modified contrast agents may allow researchers to noninvasively detect cancer and show its progression, according to research published in the March issue of The Journal of Nuclear Medicine (JNM). The technique enables researchers to visualize tumor activity at the molecular level.
"We hope this technique might be helpful for the early detection of disease," said Juergen K. Willmann, M.D., lead author of the study and assistant professor of radiology at Stanford University School of Medicine. "It may help save lives by finding cancer such as breast, ovarian or pancreatic cancer in the very early stages, when it is still curable."
In the study, researchers intravenously injected microbubbles-gas-filled spheres small enough to travel through vessels-into mice with cancers. The microbubbles, which were paired with a new peptide (a molecule that consists of a chain of amino acids), were designed to travel through the vascular system and attach to integrin-a well-characterized molecular marker that acts as a "red flag" for tumor vessel growth, or angiogenesis. Tumor vessel growth occurs when active tumor cells create certain pathways to provide the tumor with a sufficient supply of oxygen, nutrients and other factors needed for growth.
Once the gas-filled microbubbles seek out the cancers and attach to their vessel walls, they send out strong signals that are picked up by standard clinical ultrasound scanners. The imaging signals produced by the microbubbles are reflected back to the ultrasound transducer and illuminate the areas that outline the tumor, thus providing researchers with a sonogram of tumor vessel growth on a molecular level.
"Ultrasound holds great promise for the application of molecular imaging because it is widely available, relatively inexpensive and safe. There is no exposure to radiation and repetitive imaging is not a concern," said Dr. Willmann. "Furthermore, the targeted microbubbles have great potential for translation from bench to bedside-which will be explored in future studies," said Sanjiv Gambhir, M.D., Ph.D., director of the molecular imaging program at Stanford.
Contrast-enhanced ultrasound can be used to image blood perfusion in organs, to measure blood flow rate in the heart and other organs and to perform other applications-such as characterization of focal lesions in the liver. Current interest is focused on modifying contrast agents to make them specifically useful for molecular imaging. The microbubbles, paired with the new peptide that binds to tumor vessel cells as studied in the current research, may be more effective than antibody molecules, which are time-intensive to produce, are costly and may cause adverse reactions in patients.
Noninvasive imaging strategies such as the one described in the JNM study may be particularly helpful for diagnosing cancer in its earliest stages as well as for developing therapeutic agents to treat cancer and monitoring whether treatment is working.
Article written by staff at news-medical.net and adapted for the purposes of this newsletter.
American Stroke Association (ASA): Ultrasound Speeds Drainage of Brain Hemorrhages
Sonothrombolysis, a technique that combines ultrasound pulses and injection of a thrombolytic directly into a hemorrhage, appears safe and may be effective for treating hemorrhages in the brain...
Sonothrombolysis, a technique that combines ultrasound pulses and injection of a thrombolytic directly into a hemorrhage, appears safe and may be effective for treating hemorrhages in the brain, a small study showed.
All nine patients who received the treatment had a reduction in hemorrhage size after 24 hours -- an average of 59% for those with intracerebral hemorrhage and 45.1% for those with intraventricular hemorrhage -- according to David Newell, MD, co-executive director of the Swedish Neuroscience Institute in Seattle.
Seven of the patients had improvements in functioning by 30 days, and one died, Newell reported at the American Stroke Association meeting here. None had re-bleeding or intracranial infection. "We feel this is a new application for sonothrombolysis that needs to be studied further," Newell said.
"But it should hold some great promise for treatment of intracerebral hemorrhage evacuation." Although sonothrombolysis has been evaluated for clots in the legs and pulmonary emboli, Newell said it had not been evaluated for intracerebral hemorrhage, for which there are no proven treatments.
So he and his colleagues initiated the SLEUTH (Safety of Lysis with EKOS Ultrasound in the Treatment of Intracerebral and Intraventricular Hemorrhage) study to assess the safety of the approach in humans.
The mean age of the nine patients was 63 (range 38 to 83). They were required to have had spontaneous onset of an intracerebral hemorrhage of at least 25 cc or an intraventricular hemorrhage obstructing the third or fourth ventricles.
The approach involved inserting two catheters through a burr hole directly into intracerebral hemorrhages (in six patients) or intraventricular hemorrhages (in three patients) using a GPS-like neuronavigation system.
Through one catheter, low doses of recombinant tissue plasminogen activator (tPA) were administered directly into the clot (0.3 mg for intraventricular and 1 mg for intracerebral) in three doses eight hours apart.
Ultrasound pulses were then applied through the catheter continuously for 24 hours with the aim of speeding the action of the drug.
The dissolved clot was then drained through a second catheter. Portable CT scanners were used to monitor the patients for rebleeding. Functional outcomes at 30 days were measured using the National Institutes of Health Stroke Score.
Compared with two previous studies that evaluated the injection of the same doses of tPA directly into brain hemorrhages -- MISTIE and CLEAR -- this study appeared to find faster resolution of the clots for intraventricular hemorrhage (P=0.046) and a tendency toward faster resolution in intracerebral hemorrhage (P=0.074).
A clinical trial with more patients, a placebo group, and more sophisticated outcome measures is warranted, Newell said.
Article written by staff at medpagetoday.com and adapted for the purposes of this newsletter.
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