This channel contains news about the Radiological Society of North America (RSNA), including coverage of its annual meeting. RSNA is a leading resource for the radiology and all its subspecialties. This includes all areas of medical imaging, angiography, computed tomography (CT), digital X-ray, magnetic resonance imaging (MRI), nuclear imaging, ultrasound, PACS and advanced visualization. For coverage of RSNA specific to cardiovascular medicine and interventional radiology, visit our sister publication Diagnostic and Interventional Cardiology (DAIC) and its RSNA channel.
The first of three clinical scenarios presented to the panel with final recommendations. Mild features refer to absence of significant pulmonary dysfunction or damage. Pre-test probability is based upon background prevalence of disease and may be further modified by individual’s exposure risk. The absence of resource constraints corresponds to sufficient availability of personnel, personal protective equipment, COVID-19 testing, hospital beds, and/or ventilators with the need to rapidly triage patients. Contextual detail and considerations for imaging with CXR (chest radiography) versus CT (computed tomography) are presented in the text. (Pos=positive, Neg=negative, Mod=moderate). [Although not covered by this scenario and not shown in the figure, in the presence of significant resources constraints, there is no role for imaging of patients with mild features of COVID-19.] Image courtesy of the journal Radiology
An example of Philips’ TrueVue technology, which offers photo-realistic rendering and the ability to change the location of the lighting source on 3-D ultrasound images. In this example of two Amplazer transcatheter septal occluder devices in the heart, the operator demonstrating the product was able to push the lighting source behind the devices into the other chamber of the heart. This illuminated a hole that was still present that the occluders did not seal. Photo by Dave Fornell
A, Image from noncontrast head CT demonstrates symmetric hypoattenuation within the bilateral medial thalami (arrows). B, Axial CT venogram demonstrates patency of the cerebral venous vasculature, including the internal cerebral veins (arrows). C, Coronal reformat of aCT angiogram demonstrates normal appearance of the basilar artery and proximal posterior cerebral arteries. Image courtesy of the Radiological Society of North America (RSNA)
Typical CT imaging features for COVID-19. Unenhanced, thin-section axial images of the lungs in a 52-year-old man with a positive RT-PCR (A-D) show bilateral, multifocal rounded (asterisks) and peripheral GGO (arrows) with superimposed interlobular septal thickening and visible intralobular lines (“crazy-paving”). Routine screening CT for diagnosis or exclusion of COVID-19 is currently not recommended by most professional organizations or the US Centers for Disease Control and Prevention. Image courtesy of RSNA
Representative examples of the attention heatmaps generated using Grad-CAM method for (a) COVID-19, (b) CAP, and (c) Non-Pneumonia. The heatmaps are standard Jet colormap and overlapped on the original image, the red color highlights the activation region associated with the predicted class. COVID-19 = coronavirus disease 2019, CAP = community acquired pneumonia. Image courtesy of the journal Radiology
Series CT scans in 35-year-old woman with COVID-19 pneumonia. (a) Scan obtained on illness days 1 showed multiple pure ground-glass opacity (GGO) mainly in right lower lobe. (b) Scan obtained on illness days 5 showed increased extent of GGO and early consolidation. (c) Scan obtained on illness days 11 showed multiple consolidation with almost the same extent. (d) Scan obtained on illness days 15 showed a mixed pattern with a slightly smaller extent, and the perilobular consolidation might suggest the presence of organizing pneumonia. The patient was discharged on illness days 17. Image courtesy of the journal Radiology
Immunofluorescent staining performed to depict γ-H2AX foci. Representative images of γ-H2AX foci in peripheral blood lymphocytes in an 82-year-old woman who underwent standard-dose CT. (a) Nuclear DNA of four lymphocytes. (b) γ-H2AX foci (arrows). (c) Markers of DNA double-strand breaks. In this merged image, DNA is blue and γ-H2AX foci are red (arrows show small foci). γ-H2AX, a marker of DNA double-strand breaks, is a phosphorylated type of histone H2AX. Scale bar: 5 mm. Image courtesy of the Radiological Society of North America
Images in a 57-year-old woman noted to have "good prognosis" invasive cancer detected at digital breast tomosynthesis (DBT) screening. (a) Craniocaudal view of the left breast obtained with the two-dimensional digital mammography (DM) portion of the DM/DBT screening study demonstrates a subtle area of distortion in the medial left breast. (b) Single-slice image from the left craniocaudal DBT portion of the screening study shows an area of bridging distortion (circle). (c) Electronically enlarged image of the area of concern seen on the left craniocaudal view in a single DBT slice as shown in b. (d) Targeted US scan demonstrates two small adjacent irregular solid masses. US-guided core biopsy yielded an invasive carcinoma of the tubular subtype that was estrogen receptor positive, progesterone receptor positive, and human epidermal growth factor receptor 2 negative. The results of the sentinel node biopsy were negative. Image courtesy of the Radiological Society of North America
There were more than 150 companies showing some version of artificial intelligence at RSNA, but very few have FDA cleared products for sale. One of the trends seen on the floor was a movement toward AI app stores where these start-up companies can offer their wares through a larger vendor and provide a single point of contracts and IT integration for hospitals.
Examples of typical chest CT findings compatible with COVID-19 pneumonia in patients with epidemiological and clinical presentation suspicious for COVID-19 infection. This image is part of the original research, Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR, published Feb. 19, 2020, in Radiology Online.
An image from the Radiology article showing a baseline CT image of a 75 year old male with multiple patchy areas of pure ground glass opacity (GGO) and GGO with reticular and/or interlobular septal thickening. Follow-up CT images on day 3 after admission show an overlap of organizing pneumonia with diffuse alveolar damage in that it is more diffuse and associated with underlying reticulation. Read more and see 15 more images from novel coronavirus patients in the article.