By Wayne Forrest, contributing writer
    November 16, 2010

    Hybrid anatomical/functional imaging, the role of FDG, and the development of new molecular imaging agents will be among the overriding themes in nuclear medicine and molecular imaging at this year's RSNA meeting in Chicago.

    For example, Swiss researchers will demonstrate their progress on a clinical prototype of a PET/MRI system. The emerging technology will be highlighted in a presentation on Sunday, November 28, by Osman Ratib, MD, PhD, head of the radiology department at the University Hospital of Geneva (10:55 a.m.-11:05 a.m., SSA18-02, Room S505AB).

    Also at the forefront of molecular imaging abstracts will be details on the progress of new radiotracers, such as F-18 choline, according to Homer Macapinlac, MD, chairman of the department of nuclear medicine at MD Anderson Cancer Center at the University of Texas in Houston and chairman of RSNA's nuclear medicine subcommittee.

    Specifically, Italian researchers will provide details on the accuracy of F-18 choline PET/CT to detect the local recurrence of prostate cancer (Sunday, November 28, 12:05 p.m.-12:15 p.m., SSA18-09, Room S505AB).

    Given the experience of the molybdenum-99 shortage over the past two years, Macapinlac said that the nuclear medicine community is "optimistically cautious that we [will] not get any further [molybdenum-99] shortages this year. We hope that in the near future new tracers will become approved. Among the PET tracers which provide the most excitement would be in neurology for amyloid imaging."

    King Li, MD, chairman of the radiology department at the Methodist Hospital in Houston and a member of RSNA's molecular imaging abstract review subcommittee, concurred that the development of new molecular imaging agents and their transition into the clinical environment will be among the most noteworthy developments discussed at RSNA 2010.

    "I think that those [agents] are important, especially with the new method of filing for approval for clinical trials through the emergency investigational new drug [EIND] process" adopted by the U. S. Food and Drug Administration, Li said.

    In Chicago, there also will be clinical research on positron emission mammography (PEM) and how it may influence surgical planning in early-stage breast cancer (Monday, November 29, 11:40 a.m.-11:50 a.m., VM21-15, Arie Crown Theater).

    In the area of refresher courses, an interactive session titled "Improving Your PET Practice: Lessons Learned in Clinical Practice, with Emphasis on Case Studies, Image Correlation, and PET/CT" is on the schedule for Monday. The forum will discuss some common pitfalls of PET/CT image interpretation in a busy radiology practice and how to avoid interpretive errors and oversights (Monday, November 29, 8:30 a.m.-10:00 a.m., RC211, Room E450B).

    Given PET's prominent place in brain imaging, a refresher course titled "PET Brain Imaging: Current and Emerging Applications -- Emphasis on Dementia" will offer insights into cognitive disorders. This session will detail the role of FDG-PET imaging in differential diagnosis of dementia and the benefits of MRI in clinical dementia workup (Tuesday, November 30, 8:30 a.m.-10:00 a.m., RC311, Room S505AB).

    Li will host a refresher course on the "Essentials of Molecular Imaging and Systems Diagnostics for Clinical Radiologists." The presentation will focus on the definition of systems diagnostics, list the requirements for system diagnostics, and discuss the role of radiologists in this area (Tuesday, November 30, 4:30 p.m.-6:00 p.m., RC417B, Room E353A).

    "Our main push is to teach radiologists to integrate molecular imaging for a lot more information," Li said. "We can actually use existing imaging modalities to get genetic and molecular information and not wait for the development of PET agents and detection systems."

    Meanwhile, "Advances in Cardiac Nuclear Imaging: SPECT/CT and PET/CT" is part of Wednesday's refresher course schedule. Presenters will help attendees understand the technical advancements associated with new scintillation cameras and SPECT/CT and PET/CT cameras. The discussion will include the benefits of CT attenuation correction, as well as the adjunctive benefits of anatomic definition provided with CT and physiologic and functional information provided by SPECT and PET (Wednesday, December 1, 8:30 a.m.-10:00 a.m., RC511, Room N230).

    Below are highlights of the many novel molecular imaging scientific papers scheduled for presentation at RSNA 2010. To view the complete RSNA scientific program and abstracts directly, visit the conference's website by clicking here.

    Scientific and Educational Presentations
    FDG-PET/CT tops diffusion-weighted MR imaging in breast cancer staging
    Sunday, November 28 | 11:05 a.m.-11:15 a.m. | SSA18-03 | Room S505AB
    In this presentation, researchers from the University of Duisburg-Essen in Germany will compare diffusion-weighted MRI with FDG-PET/CT for breast cancer staging.
    How does FDG-PET compare to whole-body MRI in lymphoma disease?
    Sunday, November 28 | 11:15 a.m.-11:25 a.m. | SSA18-04 | Room S505AB
    Italian researchers will answer that question at RSNA 2010 in Chicago, when they present their study results showing that whole-body MRI is fast and feasible for staging and restaging lymphoma disease; however, the modality falls short in matching the accuracy of FDG-PET/CT.
    FDG-PET bests CT, MRI in detecting vasculitis and infection
    Sunday, November 28 | 11:45 a.m.-11:55 a.m. | SSA18-07 | Room S505AB
    With the help of FDG-PET, researchers at the University of Erlangen-Nürnberg in Germany are detecting vasculitis and vascular stent graft/prosthesis infection in patients for whom other cross-sectional imaging modalities are not as effective.
    F-18 choline PET/CT outpaces whole-body MRI in recurrent prostate cancer
    Sunday, November 28 | 12:05 p.m.-12:15 p.m. | SSA18-09 | Room S505AB
    Preliminary results of an Italian study show that while whole-body MRI did not match accuracy levels of F-18 choline PET/CT in detecting the local recurrence of prostate cancer, whole-body MRI is still a promising tool in restaging patients with the disease.
    MBI increases breast cancer detection in dense tissue
    Monday, November 29 | 8:55 a.m.-9:05 a.m. | VM21-03 | Arie Crown Theater
    In this paper presentation, researchers from the Mayo Clinic in Rochester, MN, will discuss how adding molecular breast imaging (MBI) to regular screening mammography for women with dense breasts increases cancer detection.
    BSGI improves breast cancer detection -- but biopsies may still be needed
    Monday, November 29 | 9:05 a.m.-9:15 a.m. | VM21-04 | Arie Crown Theater
    Breast-specific gamma imaging (BSGI) improves the detection of breast cancer, but the modality doesn't do away with the need for biopsy when indicated by mammography or ultrasound, according to researchers from Weinstein Imaging Associates in Pittsburgh.
    How well can FDG-PET scans detect colorectal adenomas?
    Monday, November 29 | 10:40 a.m.-10:50 a.m. | SSC13-02 | Room S505AB
    Although FDG-PET scans are sensitive in detecting malignancy and can detect colorectal polyps, Canadian researchers have found that the modality may not be foolproof in detecting lesions less than 10 mm in size.
    PEM shows potential for breast cancer surgical planning
    Monday, November 29 | 11:40 a.m.-11:50 a.m. | VM21-15 | Arie Crown Theater
    In this scientific session, Johns Hopkins researchers will present study results suggesting that positron emission mammography (PEM) is a helpful tool for breast cancer surgical planning in early-stage breast cancer.
    PET/CT tops CT alone for head and neck squamous cell carcinoma
    Tuesday, November 30 | 10:30 a.m.-10:40 a.m. | SSG12-01 | Room S505AB
    PET/CT is superior to high-resolution CT alone, particularly regarding sensitivity, in cases of head and neck squamous cell carcinoma, according to a study by researchers from Mount Sinai School of Medicine in New York City.
    FDG-PET/CT shows promise in post-transplant lymphoproliferative disease
    Wednesday, December 1 | 10:50 a.m.-11:00 a.m. | SSK13-03 | Room S505AB
    Researchers from the University of Nebraska Medical Center in Omaha plan to present study results at RSNA 2010 on the usefulness of FDG-PET in the early diagnosis, follow-up, and management of post-transplant lymphoproliferative disease.
    FDG-PET can help with early tumor detection in Li-Fraumeni syndrome
    Wednesday, December 1 | 11:00 a.m.-11:10 a.m. | SSK13-04 | Room S505AB
    Researchers in Brazil have found that PET/CT can be a useful clinical tool for detecting unknown and early-stage cancer sites in high-risk asymptomatic patients with Li-Fraumeni syndrome.
    F-18 NaF boosts sensitivity to detect malignancies with FDG-PET/CT
    Wednesday, December 1 | 11:20 a.m.-11:30 a.m. | SSK13-06 | Room S505AB
    On Wednesday morning, researchers from Stanford University in Stanford, CA, will show preliminary study results that "strongly suggest" dual-tracer PET/CT imaging with FDG and F-18 sodium fluoride (F-18 NaF) increases the sensitivity of detecting malignancy compared to FDG alone.
    FDG-PET/CT aids evaluation of bladder cancer patients
    Wednesday, December 1 | 3:30 p.m.-3:40 p.m. | SSM18-04 | Room S505AB
    FDG-PET/CT is helpful in accurately assessing disease and can provide significant prognostic information in patients with urothelial cancer. So concluded researchers from Johns Hopkins University in Baltimore in their study scheduled to be presented Wednesday afternoon at RSNA 2010.
    FDG-PET/CT contributes to the diagnosis of tuberculosis-induced inflammation
    Thursday, December 2 | 11:20 a.m.-11:30 a.m. | SSQ15-06 | Room S505AB
    German researchers have found that FDG-PET/CT may contribute to the diagnosis of tuberculosis-induced intraocular inflammation, especially in the case of latent and asymptomatic infection.

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