Medicexchange poll results underline high expectations and concerns with regards to diagnostic imaging procedures. Radiological personnel share high expectations and concerns with regards to diagnostic imaging procedures. Through our ongoing ‘Question of the Week’ radiologist have shared their views on cardiac imaging, the effect obesity has on healthcare and radiological imaging, and the recent advances in MRI.

According to a study in the December 6, 2006 issue of JAMA; research suggests that whole-body PET and CT scans could provide a suitable method for diagnosing the stage of colorectal cancer.

In this study Patrick Veit-Haibach, M.D., of University Hospital Essen, Germany, and colleagues evaluated the diagnostic accuracy of whole-body PET/CT colonography. This preliminary report suggests that PET/CT colonography may be at least equivalent to CT + PET with respect to tumor staging in patients with colorectal cancer. (JAMA. 2006;296:2590-2600.)

Our Medicexchange poll results found that though 87 per cent of you agreed that whole-body PET/CT will provide a suitable method as an all-in-one tumor staging and diagnostic modality for patients with colorectal cancer; respectively there were 13 per cent that didn’t.

With its recent advances and diagnostic performances 55 per cent of our Medicexchange community agreed: “Cardiac CT is ready to replace the traditionally required invasive coronary angiography or catheterization for the detection of coronary artery disease.” However, although multi-detector CT technology has made major strides in the last five years 45 per cent of you oppose its readiness for prime time.

Our recent poll results also found that 100 per cent of participants agreed; with the evolution in digital storage and compression, imaging studies should now be archived indefinitely.

In 2006, Raul N. Uppot, M.D., lead author and staff radiologist at Massachusetts General Hospital and colleagues set out to evaluate the affects obesity has on radiological imaging quality. Dr. Uppot and his colleagues retrospectively reviewed all radiological exams performed at Massachusetts General Hospital in the 15 year period between 1989 and 2003 with the phrases ‘limited due to body habitus’ and ‘habitus limited’. Dr. Uppots’ study results showed a significant difference (P < .001) between the weight of patients with habitus-limited reports and the weight of patients with reports that were not habitus limited. They also reported overall, 7778 of 5 253 014 reports were habitus limited.

In the August 2006 issue of Radiology; (Radiology 2006;240:435-439.) a peer-reviewed original research journal published by the Radiological Society of North America, reports the number of diagnostic exams rendered inconclusive due to obesity has doubled over a 15-year span.

With current crisis of obesity, the results of our Medicexchange poll indicate 100 per cent agreed: “Facilities should not be obligated to attempt diagnostic imaging procedures on patients who exceed the maximum weight limit recommended by imaging manufactures”.

During the annual oration in diagnostic radiology, Dr. Kerry M. Link, a professor of radiology, cardiology, regenerative medicine, and biomedical engineering at Wake Forest University Health Science Center stated, within heart disease, coronary heart disease is the leading cause of death, responsible for nearly 500,000 deaths, with an additional 225,000 deaths due to hypertension and other heart diseases. Heart disease is the most common disease in the U.S. and it is the single largest expense to the healthcare system.

Studies have suggested cardiac function by MRI is considered to be the gold standard technique compared to other methods. With b-SSP techniques it is said the entire set of images including systole and diastole can be acquired in less than 7 to ten seconds. The patient can also breathe freely while radiologists evaluate the heart in real time.

Although MRI is seen by many as the gold standard for imaging myocardial function and defects nearly 39 per cent of those polled in a recent Medicexchange ‘Question of the Week’ still prefer nuclear medicine for imaging myocardial defects.

On average, coronary stents are visualized with Cardiac CT; however, image quality is sometimes impaired. The sensitivity of Cardiac CT for detection of in-stent restenosis are sometimes limited by stent size, poor expansion and calcification.

Though grading of in-stent stenosis remains difficult, 87 per cent of Medicexchange ‘Question of the Week’ participant’s agreed, that CT is beneficial for the accurate assessment of stent occlusion and peri-stent disease.

To better understand how we may improve the quality of content and what is important to radiologists, we ask you for your input through our forums and ongoing ‘Question of the Week’.

We hope you continue to participate and look forward to hearing from you.

Written by Kori Graddy