Current Radiation Safety Practices in Medical Imaging

Sep 20th, 2013

Burbank, CA

US

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You will gain a fresh perspective on the purpose and policies of a well-developed Radiation Safety Program from a faculty member with relevant clinical experience.

(A,B) Images from an initial ultrasound examination showed no identifiable lesions and received a consensus ultrasound category of US-1. Nearly the entire liver is visualized, with minimal shadowing (“s”, A and B), and the examination received consensus result of VIS-A. The AFP level was 7.1 ng/mL on assessment six months before the ultrasound, 9.1 ng/mL on assessment three months before examination, and 14.2 ng/mL on assessment on exam day. The AFP result was thus assessed as positive based on a progressive increase on two consecutive tests. The atient was considered to have negative surveillance result according to LI-RADS Ultrasound Surveillance v2017, but positive surveillance result according to LI-RADS Ultrasound Surveillance v2024. (C-D) Axial arterial-phase (C) and portal-venous phase (D) T1-weighted images from subsequent gadoxetic acid-enhanced MRI show a 2-cm arterial-phase hyperenhancing observation (arrow, C) with portal-venous washout (arrow, D) in segment 7. This observation was classified on MRI as LR-5, thus meeting the present study’s reference standard for diagnosis of HCC. The mass is located in the periphery of the liver, an anatomic area where ultrasound visualization can be challenging due to shadowing.

LI-RADS ultrasound surveillance version 2024 improves HCC detection

January 22, 2025

Deep learning helps find, segment lung tumors on CT imaging

January 22, 2025

Images in a 74-year-old male patient who presented at the hospital with acute symptoms of a right hemispheric ischemic stroke and a National Institutes of Health Stroke Scale (NIHSS) score of 24. (A) Nonenhanced CT image shows no signs of early infarction, whereas (B) CT perfusion image shows a large perfusion deficit in the territory of the middle cerebral artery and anterior cerebral artery caused by an extracranial occlusion in the right internal carotid artery. (C) Digital subtraction angiography shows the occlusion in the C1 segment. The extracranial occlusion was passed, reperfused, and subsequently stented (D, E). The final contrast injection did not reveal any intracranial occlusions within the territory of the internal carotid artery (F). At the 24-hour follow-up, there was no infarction on (G) the nonenhanced CT image, and the NIHSS score had decreased to 3 points. Image courtesy of RSNA.

EVT promising in patients with extracranial ICA occlusions

January 21, 2025

Images depict a 49-year-old female participant with cryptogenic cirrhosis who presented with a 3.2-cm liver lesion. This biopsy-confirmed hepatocellular carcinoma (HCC) with an initial categorization of Liver Imaging Reporting and Data System (LI-RADS) category LR-4 (probably HCC) at CT was upgraded to LR-5 (definitely HCC) at contrast-enhanced ultrasound (CEUS). (A) Precontrast CT images in the liver show vague hypoattenuation in the medial left hepatic lobe (arrows). (B) Arterial phase images demonstrate no definite arterial phase hyperenhancement (arrows). (C) Washout and an enhancing capsule (arrows) on a late-phase image resulted in an LR-4 categorization. (D) B-mode ultrasound shows a round hypoechoic nodule (arrows). (E) An early-phase CEUS image shows clear arterial-phase hyperenhancement (arrows); (F) No washout at one minute (arrows), and (G) late, mild washout at four minutes (arrows) resulted in a CEUS LR-5 categorization.

CEUS resolves indeterminate CT, MRI liver observations

January 21, 2025

LI-RADS ultrasound surveillance version 2024 improves HCC detection

By Amerigo Allegretto

The 2024 version of the LI-RADS Ultrasound Surveillance system improves detection of hepatocellular carcinoma (HCC) over earlier iterations.

January 22, 2025

(A,B) Images from an initial ultrasound examination showed no identifiable lesions and received a consensus ultrasound category of US-1. Nearly the entire liver is visualized, with minimal shadowing (“s”, A and B), and the examination received consensus result of VIS-A. The AFP level was 7.1 ng/mL on assessment six months before the ultrasound, 9.1 ng/mL on assessment three months before examination, and 14.2 ng/mL on assessment on exam day. The AFP result was thus assessed as positive based on a progressive increase on two consecutive tests. The atient was considered to have negative surveillance result according to LI-RADS Ultrasound Surveillance v2017, but positive surveillance result according to LI-RADS Ultrasound Surveillance v2024. (C-D) Axial arterial-phase (C) and portal-venous phase (D) T1-weighted images from subsequent gadoxetic acid-enhanced MRI show a 2-cm arterial-phase hyperenhancing observation (arrow, C) with portal-venous washout (arrow, D) in segment 7. This observation was classified on MRI as LR-5, thus meeting the present study’s reference standard for diagnosis of HCC. The mass is located in the periphery of the liver, an anatomic area where ultrasound visualization can be challenging due to shadowing.

Deep learning helps find, segment lung tumors on CT imaging

By Kate Madden Yee

Using a deep-learning model with lung CT imaging shows promise for identifying and segmenting tumors, researchers have reported.

January 22, 2025

EVT promising in patients with extracranial ICA occlusions

Endovascular thrombectomy (EVT) and best medical treatment are both effective and safe options for patients with acute extracranial internal carotid artery occlusions.

January 21, 2025

Images in a 74-year-old male patient who presented at the hospital with acute symptoms of a right hemispheric ischemic stroke and a National Institutes of Health Stroke Scale (NIHSS) score of 24. (A) Nonenhanced CT image shows no signs of early infarction, whereas (B) CT perfusion image shows a large perfusion deficit in the territory of the middle cerebral artery and anterior cerebral artery caused by an extracranial occlusion in the right internal carotid artery. (C) Digital subtraction angiography shows the occlusion in the C1 segment. The extracranial occlusion was passed, reperfused, and subsequently stented (D, E). The final contrast injection did not reveal any intracranial occlusions within the territory of the internal carotid artery (F). At the 24-hour follow-up, there was no infarction on (G) the nonenhanced CT image, and the NIHSS score had decreased to 3 points. Image courtesy of RSNA.

CEUS resolves indeterminate CT, MRI liver observations

By Amerigo Allegretto

Contrast-enhanced ultrasound (CEUS) can resolve some high-risk indeterminate liver observations initially seen on CT or MRI.

January 21, 2025

Images depict a 49-year-old female participant with cryptogenic cirrhosis who presented with a 3.2-cm liver lesion. This biopsy-confirmed hepatocellular carcinoma (HCC) with an initial categorization of Liver Imaging Reporting and Data System (LI-RADS) category LR-4 (probably HCC) at CT was upgraded to LR-5 (definitely HCC) at contrast-enhanced ultrasound (CEUS). (A) Precontrast CT images in the liver show vague hypoattenuation in the medial left hepatic lobe (arrows). (B) Arterial phase images demonstrate no definite arterial phase hyperenhancement (arrows). (C) Washout and an enhancing capsule (arrows) on a late-phase image resulted in an LR-4 categorization. (D) B-mode ultrasound shows a round hypoechoic nodule (arrows). (E) An early-phase CEUS image shows clear arterial-phase hyperenhancement (arrows); (F) No washout at one minute (arrows), and (G) late, mild washout at four minutes (arrows) resulted in a CEUS LR-5 categorization.

PET/CT can rule out CAV in heart transplant patients

Cardiac PET/CT scans can effectively rule out moderate to severe cardiac allograft vasculopathy (CAV) in heart transplant patients.

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Machine learning can predict immunotherapy response in NSCLC patients

By Kate Madden Yee

Machine learning (ML) can help clinicians predict immunotherapy response in patients with inoperable non-small cell lung cancer (NSCLC).

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Current topics in mammography

By Sandy Coffta

Sandy Coffta of Healthcare Administrative Partners discusses changes in reporting and reimbursement for mammography exams.

January 17, 2025

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Surgeon General's alcohol advisory puts patient counseling at the fore

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Patient communication and education may be key for radiologists in the wake of the Surgeon General’s advisory on alcohol-related cancer risk.

January 17, 2025

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FAPI-PET shows promise for imaging gastric cancers

Gallium-68 fibroblast activation protein inhibitor (FAPI) PET/CT is a promising new method for imaging gastric cancer.

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CEM has slightly higher mean glandular dose than DBT, mammography

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Contrast-enhanced mammography (CEM) has a slightly higher mean glandular dose than other breast imaging modalities.

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ACS: Cancer mortality continues to drop

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Cancer mortality rates continue to drop -- although incidence of the disease is rising in women, according to an annual study released by the ACS.

January 16, 2025

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POCUS useful for diagnosis of retained conception tissue

By Amerigo Allegretto

Point-of-care ultrasound (POCUS) can be a useful tool for diagnosing the presence of retained conception tissue.

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Ultrasound Portable

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