Hot topics at RSNA 2010

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Lisa Fratt, Editor

Hot topics in radiology are multiple, diverse and well-addressed at RSNA 2010.

Controlling radiation dose is near the top of most lists, and RSNA 2010 offers multiple sessions considering the issue from various angles including operations, protocols, practice management and physics. “Radiation Dose: Can it be Too Low?” on Wednesday, Dec. 1, promises a lively look at this hot topic. Be sure to pair educational sessions with a tour of the show floor as vendors are touting new reconstruction techniques, monitoring software and more.

Another major and timely development occurred on the lung cancer screening front with the decision of the National Cancer Institute to halt the National Lung Cancer Screening Trial (NLST) after seeing a 20 percent mortality reduction in the target high-risk population. The decision stimulates a number of discussion points including best practices for collaboration between radiologists and referring physicians. RSNA 2010 tackles the issue of communication with referring physicians during the “What the Referring Physician Needs to Know” on Monday, Nov. 29.

Mammography has been a hot topic for decades, and RSNA 2010 promises a fresh look at the ongoing controversy. “Tailored Breast Cancer Screening” on Tuesday, Nov. 30 should bring stimulating debate and discussion on the value of various screening modalities, particularly mammography and MRI, for breast cancer detection.

Study after study suggest the value of MRI. “In the long term, I believe that MRI will become the most powerful tool we have for evaluating patients with breast disease,” predicts Gillian Newstead, MD, professor of radiology at the University of Chicago Medical Center.  She noted that breast MRI is as important among newly diagnosed breast cancer patients as it as among high-risk women. Consider for example an August study in American Journal of Roentgenology, which reported that breast MRI screening of women with only a personal, not familial, history of breast cancer was clinically valuable in finding malignancies for 12 percent of all cases, with a reasonable biopsy rate of 39 percent.

One year after the contentious release of the U.S. Preventive Services Task Force guidelines, mammography screening continues to reel. In September, a Norwegian study attributed minimal mortality reductions to screening—suggesting that increased awareness and improved treatments rather than mammograms are the main force in reducing the breast cancer death rate. While other studies have reported more positive results, ongoing scrutiny and questions continue to wreak havoc on the screening model.

“Therapy only saves lives if cancers are found early,” asserts Dan Kopans, professor of radiology at Harvard Medical School and senior radiologist in the breast imaging division at Massachusetts General Hospital in Boston.

The latest breast imaging modality to garner FDA approval—breast tomosynthesis—also should see its fair share of the RSNA spotlight as experts explore its clinical potential on Wednesday, Dec. 1.

Other clinical highlights include angiogenesis imaging, image-guided drug delivery and advanced imaging in Alzheimer’s disease diagnosis and drug development. Recently, researchers created an agent that holds potential as targeted therapy for breast cancer by combining an iron oxide nanoparticle, a tumor-targeting peptide and a therapeutic nucleic acid into one construct that can be tracked via MRI.

Earlier this fall, Eli Lilly nabbed Avid Radiopharmaceuticals, developer of florbetapir F 18 (18F-AV-45), a molecular imaging agent under investigation for detecting the presence of amyloid plaque in the brain. The compound garnered the top spot on Cleveland Clinic’s 2010 Top 10 Medical Innovations list.

IT and effective practice management are two more topics near and dear to radiologists’ hearts. Experts are providing a decent look at imaging applications on some of the hottest platforms including the Apple iPad, smart phone and iPhone on Monday, Nov. 29. iPads may not make the cut for diagnostic image interpretation, but a host of applications make the iPad a hot tool. Attendees of the sessions should be able to separate the wheat from the chaff and make a compelling case for iPad adoption.

Practice management educational offerings also are robust at RSNA 2010. Meaningful use, new payment policies and revised service models all make the grade. Find out how to qualify for incentives, stay ahead of the payment