Upending the status quo with advanced visualization

The past month has offered a few examples of the disruptive potential of advanced visualization, and how advances in imaging can improve care.

In fact, a recent survey showed one of the mainstays in radiology—PACS—could take a back seat to advanced visualization systems in the eyes of some users. A report from market research firm KLAS found that two-thirds of providers would consider using their advanced visualization system as their primary reading environment as a way of consolidating vendors.

Users may not be rushing to ditch their PACS vendors quite yet, however, as providers still desire the functionality provided by the PACS workflow they currently use.

CT angiography (CTA) is also challenging the current gold standard for the detection of cerebral aneurysms, thanks to subtraction techniques that offer bone-free visualization. A study in Radiology argued that subtracted 320-detector row volumetric CTA could be considered a first-line imaging technique for evaluation of suspected aneurysms, and could be an alternative to the more invasive and complex standard of 3D rotational digital subtraction angiography (DSA).

In a study featuring 282 consecutive patients, subtracted CTA showed 99.2 percent of aneurysms, which was superior to nonsubracted CTA and comparable to 3D DSA.

And MRI for lower back pain may, in fact, prove useful after all, though not in the way it’s commonly used. While imaging of the lower back for pain receives much scrutiny for appropriateness, functional MRI has revealed abnormalities in brain structure that predispose individuals to develop chronic pain after a lower back injury.

Published in the journal Pain, the study of 46 people with sub-acute back pain found that about half of the patients saw their pain improve regardless of whether it was treated. Those with persistent pain had abnormal fractional anisotropy in the nucleus accumbens and medial prefrontal cortex, which are regions involved with pain and emotion processing.

In a second cohort used to validate the findings, the authors found they could predict with about 85 percent accuracy which patients would have persistent back pain based solely on the MRI results. Knowing which patients will be susceptible to chronic pain could change the way back injuries are treated.

How have recent advancements in imaging changed the way you practice?

- Evan Godt
Editor – Health Imaging