Dear AuntMinnie Member,
It may be OK to cut out gadolinium contrast for some follow-up MRI scans to monitor patients with multiple sclerosis (MS), according to a research study that was the subject of our most-read article for the past week.
Gadolinium exposure has become a major patient safety issue in radiology, and researchers have been seeking ways to perform MRI scans without using the contrast material. German researchers found that gadolinium contrast wasn't necessary when performing 3-tesla MRI studies to detect new or enlarged lesions in MS patients.
The study is important because MS patients frequently receive many MRI studies as part of the management of their disease. The protocol that the group developed could reduce patient exposure to gadolinium deposition.
In another article in our MRI Community, researchers from France discussed their development of an MRI technique called R2* mapping to detect iron concentrations in the substantia nigra region of the brain. The findings could impact our understanding of how stroke affects the brain.
Docs mum on CT lung screening
One of the conditions set down by the U.S. Centers for Medicare and Medicaid Services when it approved Medicare payments for CT lung cancer screening in 2014 was that prospective recipients undergo a session of shared decision-making with their general physicians before they were referred for an exam. A new study is pointing out why that may have been a bad idea.
Compliance rates with CT lung screening among eligible individuals -- mostly high-risk current and former smokers -- are mired in the low single digits. Despite the fact that Medicare payments are available for the scans, the people who need them the most simply aren't getting them.
Why? The new study indicates that many general physicians simply aren't talking about CT lung screening with their patients. In fact, doctors talked about the scans with less than 20% of eligible patients. The findings indicate that it could be time to take a more critical look at shared decision-making and whether it's hindering access to a life-saving medical service.
In other CT news, a group from the University of Pittsburgh developed a risk model that could enable clinicians to home in even more precisely on which individuals are most suited for CT lung screening. And researchers from Johns Hopkins University found that risk of a cardiac event rises with coronary artery calcium score -- even past the threshold of 1,000 Agatston units.
Get these stories and more in our CT Community.
Benefits of mammo AI
Finally, a trove of research on artificial intelligence (AI) came out of the European Congress of Radiology (ECR) earlier this month. A number of studies addressed the benefits of AI for mammography, such as this study that found that using AI to analyze breast screening exams could lessen the load for busy screening practices. Another found that an AI algorithm helped determine which patients with pure atypical ductal hyperplasia may safely be monitored with imaging rather than be sent on to surgical excision.
More news about women's imaging can be found in our Women's Imaging Community.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
