RSNA 2019 CT Preview

Road to RSNA 2019: CT Preview

By Abraham Kim, staff writer
November 7, 2019

The vast number of CT presentations at RSNA 2019 is a testament to the modality's resilience and its value to the medical imaging community. Of the numerous factors that have contributed to CT's long-standing relevance, its adaptability certainly ranks high among them.

This year's RSNA meeting looks to serve as a reminder of just how adaptable CT continues to be: Presentations will reaffirm the utility of tried-and-true imaging techniques and also feature relatively new technologies that have already begun reshaping the approach radiologists take to common clinical applications.

Perhaps one of the best examples of this theme lies in the diagnostic evaluation of heart disease. Researchers will discuss the benefits of traditional coronary CT angiography (CCTA), one of the most reliable noninvasive methods for examining patients suspected of having coronary artery disease. At the same time, other groups will highlight the ever-growing list of evidence backing the integration of fractional flow reserve analysis derived from CCTA (FFR-CT) into coronary artery disease evaluation.

Several presentations will demonstrate the flexibility of using CT for lung cancer screening as well. Though CT lung screening was proved effective years ago, clinicians continually seek to improve upon the finer details of the test, including the optimal follow-up screening interval for negative exams and nodule management guidelines. What's more, researchers will propose making CT lung screening even more comprehensive by adding other tasks such as coronary artery calcium scoring to the exam.

Still another illustration of CT's versatility resides in ongoing efforts to reduce radiation dose through technological advancements. For their part, investigators from the Mayo Clinic and the U.S. National Institutes of Health will share how photon-counting CT scanners at their institutions allowed for dramatic dose reductions.

Other notable concepts concerning CT include the growing use of dual-energy CT, as radiologists become more familiar with the technique and the ideal parameters for different clinical indications; the application of artificial intelligence algorithms to CT scans; and the development of new methods for enhancing spatial resolution.

These topics are detailed in a selection of CT presentations covered in the list below. Those interested in the complete catalog of scientific abstracts and educational programs may access them via the RSNA 2019 meeting program.

Scientific and Educational Presentations
CT whole-heart volume predicts adverse cardiac events
Sunday, December 1 | 11:05 a.m.-11:15 a.m. | SSA03-03 | Room S105AB
Individuals with a small 3D whole-heart volume, as calculated on CT scans, have an increased risk of major adverse cardiac events, compared with those with a normal or large heart volume, according to researchers from Harvard Medical School.
DECT more cost-effective than CT, MRI for kidney lesions
Sunday, December 1 | 11:35 a.m.-11:45 a.m. | SSA11-06 | Room N230B
Dual-energy CT (DECT) may be more cost-effective than conventional CT or MRI for evaluating incidentally detected renal lesions, based on simulations from an analytical model that serve as the subject of this study to be presented on Sunday.
New CT guidance method improves lung nodule localization
Sunday, December 1 | 11:45 a.m.-11:55 a.m. | SSA24-07 | Room S404CD
Researchers from Michigan have developed a minimally invasive CT-guided technique for preoperatively marking lung nodules as accurately as standard techniques, which they will detail in their upcoming Sunday presentation.
FFR-CT may reduce downstream testing for chest pain
Monday, December 2 | 10:30 a.m.-10:40 a.m. | SSC01-01 | Room S402AB
Accounting for fractional flow reserve CT (FFR-CT) when evaluating the coronary CT angiography scans of patients with chest pain could improve patient classification and lower the rate of follow-up examinations, according to this Monday presentation.
FFR-CT, CCTA bolster emergency chest pain evaluation
Monday, December 2 | 11:20 a.m.-11:30 a.m. | SSC04-06 | Room S102CD
The combination of fractional flow reserve CT (FFR-CT) and conventional coronary CT angiography (CCTA) proved to be effective at ruling out major adverse cardiac events for emergency patients with acute chest pain in this study to be discussed on Monday.
FFR-CT values vary by coronary artery segment measured
Monday, December 2 | 11:40 a.m.-11:50 a.m. | SSC01-08 | Room S402AB
Fractional flow reserve CT (FFR-CT) values measured in the distal segment of the coronary arteries were markedly lower than those measured in the proximal and mid segments of the same arteries in a study by researchers from South Carolina.
CCTA adds value to ischemic stroke evaluation
Monday, December 2 | 3:40 p.m.-3:50 p.m. | SSE06-05 | Room E353A
Acquiring coronary CT angiography (CCTA) in addition to head CT for patients suspected of having an acute ischemic stroke can help identify potential sources of cardioembolic stroke while also providing insight into the patients' risk of coronary artery disease, according to this study to be presented on Monday.
Photon-counting CT cuts radiation dose by roughly 80%
Tuesday, December 3 | 3:00 p.m.-3:10 p.m. | SSJ22-01 | Room N226
Photon-counting CT can match the image quality of conventional sinus and temporal bone CT at approximately one-sixth the radiation dose, according to researchers from the Mayo Clinic in Rochester, MN.
AI algorithm could enhance CT lung cancer screening
Tuesday, December 3 | 3:50 p.m.-4:00 p.m. | SSJ05-06 | Room S102CD
An artificial intelligence (AI) algorithm could help radiologists improve their diagnostic accuracy on CT lung cancer screening exams, according to this presentation.
AI algorithm makes CAC viable on ultralow-dose CT
Wednesday, December 4 | 10:30 a.m.-10:40 a.m. | SSK03-01 | Room E351
Researchers from Israel have developed a denoising artificial intelligence (AI) algorithm that can make coronary artery calcium (CAC) scoring viable on ultralow-dose CT scans.
How effective is Lung-RADS for subsolid lung nodules?
Wednesday, December 4 | 10:30 a.m.-10:40 a.m. | SSK05-01 | Room N229
Current management guidelines from the Lung Imaging Reporting and Data System (Lung-RADS) slightly underestimate the malignancy of subsolid nodules found on CT lung cancer screening exams and may need to be revised, according to this study to be presented on Wednesday.
Math model optimizes CT radiation for liver cancer
Wednesday, December 4 | 10:30 a.m.-10:40 a.m. | SSK18-01 | Room E353C
Researchers from Duke University have developed a mathematical model that can calculate the ideal CT radiation dose for liver cancer detection by weighing the potential harms of CT radiation against the risk of an incorrect diagnosis.
New method bolsters analysis of repeat CT exams
Wednesday, December 4 | 10:40 a.m.-10:50 a.m. | SSK18-02 | Room E353C
A team of investigators from Wisconsin has developed an automated informatics-based method for identifying repeat CT exams that may help refine CT protocols and reduce the rate of unnecessary scans.
Is it time to individualize CT lung screening intervals?
Wednesday, December 4 | 10:50 a.m.-11:00 a.m. | SSK05-03 | Room N229
Tailoring the interval between baseline and follow-up CT lung screening exams based on an individual's risk of lung cancer could safely reduce the rate of unnecessary screening exams, say researchers from Italy.
CAC found on CT lung screening spurs management changes
Wednesday, December 4 | 11:00 a.m.-11:10 a.m. | SSK05-04 | Room N229
Coronary artery calcium (CAC) scoring should be integrated into CT lung cancer screening exams, according to researchers from Massachusetts General Hospital.
CTPA usage rates on the rise for PE in pregnant women
Wednesday, December 4 | 11:10 a.m.-11:20 a.m. | SSK06-05 | Room S103AB
The use of CT pulmonary angiography (CTPA) to evaluate pregnant women suspected of having a pulmonary embolism (PE) has increased over the past two decades, despite low detection rates, researchers from Switzerland will report in this presentation.
CTPA vessel density predicts mortality in PE patients
Wednesday, December 4 | 11:20 a.m.-11:30 a.m. | SSK06-06 | Room S103AB
High pulmonary artery density on CT pulmonary angiography (CTPA) scans was associated with an increased risk of death in patients with pulmonary embolism (PE) in this study to be presented on Wednesday.
Review panel helps reclassify CT lung screening exams
Wednesday, December 4 | 11:30 a.m.-11:40 a.m. | SSK05-07 | Room N229
Establishing a multidisciplinary panel to review positive CT lung cancer screening exams may help clinicians identify the most appropriate follow-up recommendations for screening participants, researchers will report in this Wednesday presentation.
International team sets benchmark DRLs for CT radiation
Wednesday, December 4 | 11:40 a.m.-11:50 a.m. | SSK18-08 | Room E353C
Researchers from the U.S. and Germany have established target and benchmark diagnostic reference levels (DRLs) for 10 clinical indications for CT based on data from an international dose registry.
DECT plus CT enhances evaluation of pulmonary lesions
Wednesday, December 4 | 3:00 p.m.-3:10 p.m. | SSM05-01 | Room N226
Together, the combination of dual-energy CT (DECT) and conventional CT can differentiate primary lung cancer from lung metastases more effectively than either of the techniques alone, according to this study to be presented on Wednesday.