Radiological Society of North America, Nov. 29-Dec. 4, 2009
The Radiological Society of North America's 95th Scientific Assembly and Annual Meeting took place Nov. 29 to Dec. 4 in Chicago and attracted more than 57,000 attendees from around the world. The meeting featured more than 2,400 scientific presentations and posters covering recent trends in radiological research, more than 1,800 education and informatics exhibits, and an expert panel discussion of revised screening mammography guidelines issued by the U.S. Preventive Services Task Force.
"The theme of this year's meeting was 'Quality Counts,' which not only refers to the need to track the performance of radiologists but also to track patient outcomes and monitor the appropriateness of ordering various imaging studies," said Scientific Program Committee chair, Robert M. Quencer, M.D., of the University of Miami. "As everyone realizes, the over-ordering of imaging studies is a major concern not only to radiologists but to all of health care."
Meeting highlights included the Eugene P. Pendergrass New Horizons Lecture delivered by Graeme M. Bydder of the University of California in San Diego. "He talked about the buried information in magnetic resonance scanning," Quencer said. "We basically only take advantage of the subjective portion of magnetic resonance imaging. But in the depths of all that imaging is important information that needs to be extracted and probably will be in the future."
An expert panel comprising Mary C. Mahoney, M.D., of the University of Cincinnati Medical Center; W. Phil Evans, M.D., of the University of Texas Southwestern Medical Center in Dallas; Stephen A. Feig, M.D., of the University of California Irvine School of Medicine; and Daniel B. Kopans, M.D., of Massachusetts General Hospital in Boston criticized the U.S. Preventive Services Task Force, which recently advised against routine mammography in women under 50 and over 75 years of age, and screening women aged 50 to 74 only every other year.
The panel voiced support for the American Cancer Society guidelines, which recommend annual mammograms for all women aged 40 years and older.
"Deaths from breast cancer have dropped by 30 percent since 1990 when mammography screening beginning at age 40 became more widespread," Kopans said. "Current American Cancer Society guidelines have been shown to save lives. The Task Force, by its own admission, said women will lose their lives. That doesn't seem to be much of a choice."
"The net effect of the new guidelines is that screening would begin too late and its effects would be too little," Feig said. "We would save money, but lose lives."
Multiple studies presented at the meeting showed the benefits of enhanced imaging in subgroups of women at high risk of breast cancer. Vilert Loving, M.D., of the University of Washington Medical Center in Seattle presented results of a retrospective review of 830 women under the age of 30 with focal breast signs or symptoms who underwent 1,123 targeted ultrasound examinations, which detected three malignancies.
"All cancers were detected with ultrasound, suggesting that mammography is not indicated in this setting," the authors conclude. "The cancer yield from biopsy was extremely low at 1.8 percent. Therefore, close ultrasound surveillance may be a preferred alternative to tissue sampling in this patient population."
Two authors reported financial relationships with General Electric Company.
Other new research suggested that high-frequency ultrasound with elastography can accurately distinguish skin cancers from benign skin conditions. Presented by Eliot L. Siegel, M.D., of the University of Maryland School of Medicine in Baltimore, the study involved 40 patients with malignant tumors and non-malignant skin conditions.
The researchers found that high-frequency ultrasound accurately characterized the depth and extent of lesions. They also found that elastography identified 98 percent of lesions that had malignant findings on biopsy, and 82 percent of benign lesions. The elasticity ratio between normal skin and the adjacent skin lesion was significantly lower for benign cystic lesions (0.04 to 0.3) than for malignant lesions (greater than 10), suggesting that the technique could be used to spare patients needless biopsies.
"Dermatologists tend to biopsy any lesions that seem visually suspicious for disease," co-author Bahar Dasgeb, M.D., of Wayne State University in Detroit, said in a statement. "Consequently, many benign lesions are needlessly biopsied in order to avoid the risk of missing a potentially deadly melanoma."
One author reported financial relationships with General Electric Company and other technology companies.
Another study presented by Reena Malhotra, M.D., of the University of California in San Diego, showed that magnetic resonance imaging can accurately identify placenta accreta, the leading cause of death for women during childbirth. The researchers studied 108 women who were referred for imaging, and found that imaging had a 90.1 percent accuracy rate in detecting placenta accreta.
"Our findings demonstrate that MRI is an extremely useful adjunct to ultrasound for assessing this potentially life-threatening obstetric condition," Malhotra said in a statement. "Having placenta accreta is not necessarily a bad prognostic indicator for the pregnancy. It is not knowing about the condition that is potentially life threatening. Accreta needs to be diagnosed ahead of time so that delivery can be planned."
RSNA: MRI May Improve Breast Cancer Detection Rate
THURSDAY, Dec. 3 (HealthDay News) -- In women at high risk of breast cancer, adding magnetic resonance imaging after three years of screening with mammography and ultrasound increases the cancer detection rate, according to research presented this week at the annual meeting of the Radiological Society of North America, held from Nov. 29 to Dec. 4 in Chicago. In other news, for women aged 30 to 39 years with focal signs or symptoms, adding mammography to ultrasound may not significantly increase the cancer detection rate.
RSNA: Pediatric Back Pain Linked to Lumbar Disc Disease
WEDNESDAY, Dec. 2 (HealthDay News) -- In children presenting with non-traumatic back pain, lumbar disc disease is prevalent, according to research presented this week at the annual meeting of the Radiological Society of North America, held from Nov. 29 to Dec. 4 in Chicago.
RSNA: Mammograms May Increase Breast Cancer Risk
TUESDAY, Dec. 1 (HealthDay News) -- In women at high risk of breast cancer, low-dose radiation from annual mammography may be associated with an increased risk of the disease, according to research presented this week at the annual meeting of the Radiological Society of North America, held from Nov. 29 to Dec. 4 in Chicago.
RSNA: Many Abdominal/Pelvic CT Scans May Not Be Needed
TUESDAY, Dec. 1 (HealthDay News) -- More than one-third of abdominal/pelvic computed tomography (CT) imaging studies are unindicated and unnecessarily expose patients to potentially hazardous excess radiation, according to research presented this week at the annual meeting of the Radiological Society of North America, held from Nov. 29 to Dec. 4 in Chicago.
RSNA: Remote Diagnosis Feasible for Acute Appendicitis
TUESDAY, Dec. 1 (HealthDay News) -- A handheld device or mobile phone equipped with special software may enable radiologists to accurately diagnose acute appendicitis from a remote site, according to research presented this week at the annual meeting of the Radiological Society of North America, held from Nov. 29 to Dec. 4 in Chicago.