Lorraine Drapek, DNP, nurse practitioner, radiation oncology, GI service, Massachusetts General Hospital, explains the roles of advanced practice providers in radiation therapy. She spoke on this topic at ASTRO 2019 at a session that reviewed the integration of APPs into radiation oncology practice to enhance clinical care. This includes but is not limited to: on-treatment management, symptom and acute toxicity management during treatment, inpatient consultations, procedural assistance, treatment planning, follow-up, survivorship and research.

Bill Hartsell, M.D., medical director of the Northwestern Medicine Proton Center in Warrenville, Ill., discusses the outcomes of a trial investigating the use of a hydrogel spacer to hold the rectum away from the prostate during radiation therapy treatments. The trial was presented at the 2019 American Society for Radiation Oncology (ASTRO) annual meeting. 

Read the article "Augmenix Announces Positive Three-Year Long-Term Data for SpaceOAR Hydrogel Spacer"

Read the article "Latest Advances in Prostate Cancer Radiotherapy"

More coverage of ASTRO 2019

Clifford Robinson, M.D., associate professor of radiation oncology, chief of the SBRT (stereotactic body radiation therapy) service, director of clinical trials, Washington University, St. Louis, Washington University School of Medicine in St. Louis, explains the longer term results of cardiac radiotherapy ablation to treat ventricular tachycardia. 

The results of the ENCORE-VT study were presented at ASTRO 2019.

Read the article "Noninvasive Radioablation Offers Long-term Benefits to High-risk Heart Arrhythmia Patients"

More coverage of ASTRO 2019

ITN Associate Editor Jeff Zagoudis speaks with Vinai Gondi, M.D., co-director of the Brain Tumor Center at the Northwestern Medicine Cancer Center, about the long-term results of a radiation therapy technique called hippocampal avoidance to preserve neurocognitive function for cancer patients with brain metastases at the 2019 American Society for Radiation Oncology (ASTRO) annual meeting.

Watch the VIDEO: Advancements in Radiation Therapy for Brain Cancer and the VIDEO: Multidisciplinary Treatment of Brain Tumors, a previous two-part interview with Gondi.

Read the article "Hippocampal Avoidance Using IMRT Now Recommended as Standard of Care for Brain Metastases"

This is an example of the Mirada DLCExpert deep learning software that automatically identifies organs, segments and auto-contours them as the first step in creating radiation oncology treatment plans. This example of a segmented prostate computed tomography (CT) scan being used to plan radiotherapy was created without any human intervention. It was demonstrated at the American Association of Physicists in Medicine (AAPM) 2019 meeting. 

This example shows OAR Space hydrogel (outlined in blue) injected to create space between the prostate and the rectum to prevent damage to that radiation sensitive structure. The gel is hard to identify on the CT scan because it looks like part of the rectum or prostate. But the softwares AI has been trained to identify it when present.

The DLCExpert software was cleared by the FDA in July 2018 and was first shown at ASTRO 2018. It automatically identifies anatomical structures and contours them to save staff time. The files created by the software are vendor neutral and can be imported into any vendor’s treatment planning system. Read more about this software. 

Find more news and video from AAPM

This is a lung cancer tumor radiotherapy treatment plan for the Accuray CyberKnife system demonstrated at the American Association of Physicists in Medicine (AAPM) 2019 meeting. The blue lines are the radiation beam lines that are shot from different positions to all intersect in the tumor to deliver the prescribed amount of radiation and prevent damage to surrounding healthy tissue. The beams also are planned around the critical structure organs near the target tumor to limit their dose. The organs are color coded to differentiate them on the treatment plan and to help with the estimated radiation dose each receives based on the plan. After the plan is optimized, it is fed into the radiotherapy treatment system computer to deliver the treatment once the patient is positioned on the treatment table exactly as they are in the CT scans used to create the plan. 

Find more news and video from AAPM

Shimadzu displayed the FluoroSpeed X1 conventional radiographic fluoroscopy (RF) system at the Association for Medical Imaging Management (AHRA) 2019 meeting in July. The system was pending U.S. Food and Drug Administration (FDA) approval at AHRA, but received FDA 510(k) clearance in early August 2019.

The system features a 33-inch aperture, large enough to place a wheelchair inside. It can be rotated 90 degrees in either direction and the deck can be parked in any position, making it easier for patients to get on and off the 660-pound weight table. The FluoroSpeed X1 offers controls that are ergonomic for technologists, with duplicate controls on each side for either a left- or right-handed tech. The machine also has a large aperture to allow swallow studies.

The FluoroSpeed X1 comes equipped with a 17 x 17-inch dynamic digital X-ray detector (FPD) in the table bucky, allowing it to both be used for fluoroscopy as well as radiographic exams.

Read more about the FluoroSpeed X1: Shimadzu Medical Systems Receives FDA 510(k) for FluoroSpeed X1 RF System

Interact with a 360 photo of a Shimadzu FluoroSpeed X1 Fluoroscopy imaging system
 

This is a quick walk around of the GE Healthcare Cardiographe dedicated cardiac CT system on display at the Society Of Cardiovascular Computed Tomography (SCCT) 2019 meeting. It was designed specifically for cardiac imaging and so has a very compact footprint so it can be used in an office setting or small room. It offers a fast gantry rotation speed to freeze cardiac motion and has large enough anatomical coverage to view the scan the entire heart in one rotation.

One of these systems was recently installed at St. Paul’s Hospital in Vancouver, Canada, where they have an extensive structural heart program. Read more about this intall.

Find more information on this system in these related articles:

New Cardiovascular CT Technology Entering the Market

New Technology Highlights on the ACC 2019 Exhibit Floor

Nate Bachman, graduate research assistant in the Human Cardiovascular Physiology Lab of the Dept. of Health and Exercise Science at Colorado State University, describes how he and fellow researchers used multiple types of cardiac imaging to evaluate the health of athletes who compete in endurance events lasting six hours or more, and what the results may suggest for future screening.

Watch the VIDEO: Key Topics for Radiology Administrators at AHRA 2019, an interview with AHRA President Chris Tomlinson, CRA, FAHRA, and President-elect Jacqui Rose, CRA, FAHRA.

Pierre Qian, MBBS, cardiac electrophysiologist fellow, Brigham and Women's Hospital, explains how his facility is working with radiation oncology to use radio therapy to noninvasively ablate ventricular tachycardia (VT). He spoke on this topics during a joint electrophysiology session by the Heart Rhythm Society (HRS) and the Society of Cardiovascular Computed Tomography (SCCT) at the SCCT 2019 meeting.

Find more SCCT news and videos

Cynthia McCollough, Ph.D., director of the Mayo Clinic CT Clinical Innovation Center, professor of medical physics and biomedical engineering and the 2019 president of the American Association of Physicists in Medicine (AAPM), shares her insights on the latest advances in computed tomography (CT) imaging technology. She spoke at the 2019 AAPM meeting. She also did an interview at AAPM on her president's theme for the 2019 meeting - VIDEO: Bridging Diversity in Medical Physics to Improve Patient Care.

Find more news and videos from AAPM.

Related CT Technology Content:

New CT Technology Entering the Market

VIDEO: Advances in Cardiac CT Imaging — Interview with David Bluemke, M.D.

Expanding Applications for Computed Tomography

VIDEO: Overview of Cardiac CT Trends and 2019 SCCT Meeting Highlights —Interview with Ron Blankstein, M.D., direct

VIDEO: 10 Tips to Improve Cardiac CT Imaging — Interview with Quynh Truong, M.D.

FFR-CT: Is It Radiology or Cardiology?

VIDEO: ITN Editor's Choice of the Most Innovative New Technology at RSNA 2018

VIDEO: Using Advanced CT to Enhance Radiation Therapy Planning — Interview with Carri Glide-Hurst, Ph.D.

VIDEO: Tips and Tricks to Aid Cardiac CT Technologist Workflow

Managing CT Radiation Dose

VIDEO: ITN Editor's Choice of Most Innovative New Cardiac CT Technology at SCCT 2017

New Developments in Cardiovascular Computed Tomography at SCCT 2017

VIDEO: Role of Cardiac CT in Value-based Medicine — Leslee Shaw, Ph.D.

Advances in Cardiac Imaging Technologies at RSNA 2017

VIDEO: The Future of Cardiac CT in the Next Decade — Interview with Leslee Shaw, Ph.D.

VIDEO: What to Consider When Comparing 64-slice to Higher Slice CT Systems — Interview with Claudio Smuclovisky, M.D. 

Mahadevappa Mahesh, Ph.D., chief of medical physicist and professor of radiology and medical physics, Johns Hopkins University, Baltimore, and treasurer of the American Association of Physicists in Medicine (AAPM), explains some of the trends in medical physics and new features of the AAPM 2019 meeting. 

Watch the related VIDEO: Bridging Diversity in Medical Physics to Improve Patient Care — Interview with AAPM President Cynthia McCollough, Ph.D., at the 2019 AAPM meeting.
 

Find more news and videos from AAPM.

Cynthia McCollough, Ph.D., director of the Mayo Clinic Computed Tomography (CT) Clinical Innovation Center, professor of medical physics and biomedical engineering, and the 2019 president of the American Association of Physicists in Medicine (AAPM), explains the "building bridges" theme of the 2019 AAPM meeting. 

This theme was the focus of her president’s address at the 2019 AAPM meeting. She spoke on the theme of diversity and how to break down the barriers between various minorities, male-female, religion, national origin, etc. She gave many photo examples of how we pigeon hole people into neat categories and that we often say we have equally in society, however her images showed recent images of big political summits where there are no women present, or they were the secretaries in the background. She said in medical practice, department administration and collaboration on projects, people need to be cognoscente of bias they have engrained by culture for which they may not even be aware.

She showed a slide of the AAPM membership makeup by generation and said members need to keep in mind the way each generation thinks and communicates varies by their generation's life experience and upbringing. McCollough said understanding these differences can help bridge perceived gaps in communication. 

Find more news and videos from AAPM.

Stephen Sorensen, Ph.D., DABR, chief of medical physics, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, explains the first commercial use of the Zap-X stereotactic radio surgery (SRS) brain radiotherapy system. The system uses a capsule-like shield to surround the gantry and patient, eliminating the need for expensive room build outs requiring vaults. The goal of the system is to expand SRS brain therapy by making it easier and less expensive to acquire the treatment system. Sorensen spoke about this system in sessions at the American Association of Physicists in Medicine (AAPM) 2019 meeting.

Find more news and videos from AAPM.

Ron Blankstein, M.D., director of cardiac computed tomography, Brigham and Women's Hospital, and associate professor of medicine and radiology, Harvard Medical School, offers an overview of the recent trends in cardiac CT and some of the new highlights at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting. He said key topics included integration of artificial intelligence into CT systems, the integration of CT calcium scoring into the 2018 American Heart Association (AHA) cholesterol management guidelines, structural heart assessments for transcatheter valve and left atrial appendage (LAA) occlusion, and sessions with paertner societies that explain the roll of CT in interventional cardiology and electrophysiology.

Find more SCCT news and videos

Khan Siddiqui, M.D., founder and CEO of HOPPR, discusses the economic advantages and costs presented by artificial intelligence (AI) applications in radiology, as well as potential strategies for healthcare providers looking to add AI to their armamentarium, at the 2019 Society of Imaging Informatics in Medicine (SIIM) annual meeting.

ITN Associate Editor Jeff Zagoudis speaks with Don Dennison, healthcare IT consultant and Chris Roth, M.D., associate professor of radiology, vice chair, information technology and clinical informatics, and director of imaging informatics strategy at Duke University Medical Center, about how to find the right people to deploy a successful enterprise imaging strategy.

Watch part 1 of the interview at the 2019 Society for Imaging Informatics in Medicine (SIIM) conference.

Sudhen Desai, M.D., FSIR, interventional radiologist at Texas Children's Hospital, editor of IR Quarterly for the Society of Interventional Radiology (SIR) and on the Board of Directors for the Society of Physician Entrepreneurs, explained how artificial intelligence (AI) can assist in pediatric imaging and the pitfalls of training AI systems. He spoke at the 2019 Radiology AIMed conference. 

Deep learning algorithms require large amounts of patient case data to train the systems to read medical images automatically without human intervention. However, in pediatrics, there are often much lower numbers of normal and abnormal scans that can be used compared to vast amounts of adult exams available. This makes it difficult to train systems, so AI developers are coming up with innovative new ways to train their software. Compounding issues with training pediatric imaging AI is that the normal ranges change very quickly for young children due to their rapid development. He explained what is normal for a 2-year-old may not be normal for a 5-year-old.

Desai and other pediatric physicians who spoke at the conference said AI could have a big impact on pediatric imaging where there are not enough specialists for the increasing image volumes.

Related content:

VIDEO: Implementation of Artificial Intelligence Tools in Radiology Practice — Interview with Lawrence Tanenbaum, M.D.

VIDEO: AI That Second Reads Radiology Reports and Deals With Incidental Findings — Interview with Nina Kottler, M.D.

Technology Report: Artificial Intelligence at RSNA 2018

VIDEO: Implementation of Artificial Intelligence Tools in Radiology Practice

Nina Kottler, M.D., vice president of clinical operations, Radiology Partners, explains how the company developed its own artificial intelligence (AI) application to check the accuracy of radiologists' reports as they dictated and to follow-up automatically on incidental findings. She spoke at the 2019 Radiology AIMed conference.

She said the AI sits on top of Radiology Partners' natural language processing application and will immediately flag any comments that do not appear to make sense or might need clarification. Instead of forcing radiologists to change their workflow to create structured reports, Kottler said this AI software helps adapt the existing workflow to make the reports more consistent and able to be data mined later. 

Related content:

VIDEO: Implementation of Artificial Intelligence Tools in Radiology Practice — Interview with Lawrence Tanenbaum, M.D.

VIDEO: Artificial Intelligence May Assist in Pediatric Imaging — Interview with Sudhen Desai, M.D.

Technology Report: Artificial Intelligence at RSNA 2018

VIDEO: Implementation of Artificial Intelligence Tools in Radiology Practice