Dr. Geoffrey Rubin

Economics
6 things new dept. chairs should know about capital budgets
You're a newly minted department chair, and you're about to attend your first capital budget meeting, where a proposal for a new MRI scanner is on the agenda. How should you handle it? Fortunately, we have a few tips from Dr. Geoffrey Rubin from Duke University and the Radiology Leadership Institute.
September 4, 2017
2017 09 01 17 32 6556 Rubin Geoffrey 2017 400
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Emergency Radiology
ED patients prefer empathetic communication for incidental findings
Incorporating patient preferences into communication may improve understanding and follow-up in addressing incidental findings.
Representative axial fused F-18 FDG-PET/MRI images and corresponding anatomic MRI images from a patient imaged at baseline and after initiation of androgen deprivation therapy are shown. Each row displays a distinct vascular territory. White arrows indicate focal areas of increased tracer uptake within the arterial wall, where spherical volumes of interest (VOIs) were placed for maximum standardized uptake value (SUVmax) measurement. Additional VOIs were placed in the superior vena cava and inferior vena cava for blood-pool activity sampling. SUVmax values from the arterial VOIs were extracted on the corresponding PET images and normalized to the blood-pool mean standardized uptake value to derive the maximum target-to-background ratio.
Molecular Imaging
PET/MRI detects arterial inflammation in prostate cancer patients
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CT
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PET/MRI detects arterial inflammation in prostate cancer patients
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Androgen deprivation therapy (ADT) is widely used in advanced prostate cancer, yet is associated with increased cardiovascular events such as stroke and heart attacks.
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Representative axial fused F-18 FDG-PET/MRI images and corresponding anatomic MRI images from a patient imaged at baseline and after initiation of androgen deprivation therapy are shown. Each row displays a distinct vascular territory. White arrows indicate focal areas of increased tracer uptake within the arterial wall, where spherical volumes of interest (VOIs) were placed for maximum standardized uptake value (SUVmax) measurement. Additional VOIs were placed in the superior vena cava and inferior vena cava for blood-pool activity sampling. SUVmax values from the arterial VOIs were extracted on the corresponding PET images and normalized to the blood-pool mean standardized uptake value to derive the maximum target-to-background ratio.
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Elizabeth McDonald, MD, shares results from her team's study on how GLP-1s may have beneficial effects on breast cancer risk.
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Subjects with moderate and severe CAC scores on nongated CT had significantly higher risk of coronary heart disease risk.
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Median progression-free survival was 17.7 months with TACE-ablation versus 7.3 months with TACE alone.
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MRI may help predict heart disease risk in patients with diabetes
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The SCAN-MRI risk score outperformed established risk models.
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Representative cardiac MRI strain images and analysis. Images in the two-, four-, and three-chamber views for strain analysis (left) and left ventricular global longitudinal strain (GLS) and global early diastolic longitudinal strain rate (eGLSR) curves (right) are shown. (A) Example images and GLS and eGLSR curves in a 37-year-old male participant with diabetes mellitus (DM) without events during follow-up after cardiac MRI. (B) Example images and GLS and eGLSR curves in a 45-year-old male participant with DM who had heart failure hospitalization during follow-up after cardiac MRI. In the left images, blue represents higher myocardial strain (higher absolute values of negative strain), whereas red represents reduced strain. In the curves, blue represents GLS, whereas orange represents eGLSR. The left y-axis denotes GLS (%), the right y-axis represents eGLSR (per second), and the x-axis denotes time (milliseconds). For these strain parameters, a lower absolute value indicates more severe myocardial functional impairment; accordingly, GLS and eGLSR were more impaired in participants with events compared with those without events.
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The proposed rule includes several positive code-level changes for nuclear medicine providers.
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Bar graphs show comparison of volume CT dose index (CTDIvol) (A) achievable doses (50th percentile) and (B) diagnostic reference levels (75th percentile) between 2014 (see reference 4 by Kanal et al) and 2025 (present study) for 10 common CT examination types performed without contrast (w/o) and with contrast (w/). Across all 10 adult CT examination categories, CTDIvol achievable doses and diagnostic reference levels generally decreased from 2014 to 2025, with the largest reductions for torso examinations (chest; abdomen-pelvis; and combined chest, abdomen, and pelvis), intermediate reductions for neck and cervical spine, and minimal change for head examinations.
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Images in a 70-year-old asymptomatic woman with a prior excisional biopsy in the left breast yielding lobular carcinoma in situ 3 years earlier. Screening contrast-enhanced mammography (CEM) was performed, which was considered a prevalence screen as the woman had no prior breast MRI in the past 3 years and no prior CEM. (A) Low-energy (26–30 kVp) mediolateral oblique (MLO) and (B) craniocaudal (CC) views show surgical clips but no abnormality. (C) Recombined MLO and (D) CC images show an enhancing mass in the medial left breast (arrows). Biopsy revealed invasive lobular carcinoma. Size was 0.2 cm; tumor grade II/III; negative lymph nodes; and estrogen receptor–positive, progesterone receptor–positive, and human epidermal growth factor receptor 2–negative.
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If today's MRI safety standard of care were followed, would MRI accidents be impossible, or nearly impossible?
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