Videos | Enterprise Imaging | February 27, 2019

VIDEO: What to Look for in Enterprise Imaging Systems

Steve Holloway, principal analyst and company director for the healthcare market research firm Signify Research, explains the key trends he is seeing in radiology enterprise imaging systems. He spoke to ITN at the 2019 Healthcare Information Management and Systems Society at (HIMSS) conference.  

Additional HIMSS 2019 coverage.

Watch the RSNA 2018 VIDEO: Technology Report — Enterprise Imaging

Recent Videos View all 586 items

Coronavirus (COVID-19) | May 11, 2021

Yael Eshet, M.D., MSc, a diagnostic radiology specialist at Sheba Medical Center in Israel, was the lead author on a recent study that showed COVID-19 (SARS-CoV-2) vaccine adenopathy can persist more than 6 weeks. This swelling of lymph nodes is similar to what is seen cancer and infections and the new findings show it can last longer than 7-10 weeks. The current recommended time people should delay medical imaging is 6 weeks after receiving a COVID vaccine to avoid a misdiagnosis,[2] but this new study shows there is increased inflammation shown on PET-CT imaging for much longer.

These were the findings in the Radiology published study "Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination."[1]

Researchers using fluorodeoxyglucose (FDG)-positron emission tomography (PET) have found increased FDG uptake in the lymph nodes of patients 7-10 weeks past their second mRNA-based Pfizer-BioNTech COVID-19 vaccination. This new information indicates a persistent immune response that could be mistaken on imaging exams for serious conditions like lymphoma over a much longer period of time.

Recent recommendations for post-vaccine lymphadenopathy advise scheduling routine imaging, such as screening mammography, before, or at least 6 weeks after, the final vaccination dose to eliminate false positive results. However, this new research showed that avid axillary lymph node uptake was present beyond 6 weeks after the second vaccination in more than 29% of the patients in the study cohort.

The authors stated “This study shows that avid axillary lymph node uptake on FDG PET/CT can be detected in more than a quarter of our patient population even beyond 6 weeks after the second dose of the mRNA-based COVID-19 vaccination. Compared to a previous study showing normalization of FDG uptake within 40 days of receiving an inactivated H1N1 influenza vaccine, we found uptake persistence even at 70 days. Physicians should be aware of this potential pitfall.”

Some images in this video are from another Radiology study, which showed PET tracer uptake at the COVID vaccine injection site and other examples of axillary adenopathy.[3]

 

Related COVID Vaccine Axillary Adenapathy Content:

COVID-19 Vaccine Can Cause False Positive Cancer Diagnosis

Help Spread Awareness of Potential COVID-19 Vaccine Imaging Side-effects

VIDEO: COVID Vaccine May Cause Enlarged Lymph Nodes on Mammograms — Interview with Constance "Connie" Lehman, M.D.

COVID-19 Vaccination Axillary Adenopathy Detected During Breast Imaging

PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

Find more radiology related COVID content 

References:

1. Yael Eshet, Noam Tau1, Yousef Alhoubani, Nayroz Kanana, Liran Domachevsky, Michal Eifer. Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination. Radiology. Published Online:Apr 27 2021https://doi.org/10.1148/radiol.2021210886.

2. Constance D. Lehman, Leslie R. Lamb, and Helen Anne D'Alessandro. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach American Journal of Roentgenology. 10.2214/AJR.21.25688.

3. Can Özütemiz, Luke A. Krystosek, An L. Church, Anil Chauhan, Jutta M. Ellermann, Evidio Domingo-Musibay, Daniel Steinberger. Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncology Patients. Radiology. Published Online:Feb 24 2021https://doi.org/10.1148/radiol.2021210275.

 

Point-of-Care Ultrasound (POCUS) | April 01, 2021

Here are two quick clinical examples of point-of-care ultrasound (POCUS) lung imaging and cardiac imaging using a GE Vscan Air device. The examples show an abnormal lung image with B-lines. The second clip shows a healthy heart in a parasternal color Doppler image.

The GE Healthcare Vscan Air is a cutting-edge, wireless pocket-sized ultrasound that provides crystal clear image quality, whole-body scanning capabilities, and intuitive software. The pocket-sized ultrasound system was originally introduced in 2010, and as of early 2021, there are over 30,000 Vscan systems in use. The new Vscan Air features a wireless ultrasound probe.

Read more in the article GE Healthcare Unveils Vscan Air Wireless Handheld Ultrasound

Find more POCUS news and video

Breast Imaging | March 26, 2021

Constance "Connie" Lehman, M.D., Ph.D., chief of breast imaging, co-director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital, and professor of radiology at Harvard Medical School, explains issues and suggested guidelines for women who receive the COVID-19 vaccine and need to get a mammogram. In the first three months since the vaccines have been released, there have been numerous case reports of the vaccine causing swollen lymph nodes. This is would usually raise a red flag for breast cancer, but is normal for many women receiving the vaccine as their body's immune system gears up against the virus. 

Lehman said cases reports of axillary adenopathy have been identified on breast imaging after coronavirus disease (COVID-19) vaccination and are rising. Lehman et al. proposed a pragmatic management approach in a recent article in the American Journal of Roentgenology (AJR).[1]

In the settings of screening mammography, screening MRI and diagnostic imaging work-up of breast symptoms, with no imaging findings beyond unilateral axillary adenopathy ipsilateral to recent (prior six weeks) vaccination, they report the adenopathy as benign with no further imaging indicated if no nodes are palpable six weeks after the last vaccine dose. 

For patients with palpable axillary adenopathy in the setting of ipsilateral recent vaccination, clinical follow-up of the axilla is recommended. In all these scenarios, axillary ultrasound is recommended if clinical concern persists six weeks after vaccination. 

In patients with recent breast cancer diagnosis in the pre- or peri-treatment setting, prompt recommended imaging is encouraged as well as vaccination (in the thigh or contralateral arm). The recommendations align with the ACR BI-RADS Atlas and aim to: 1) reduce patient anxiety, provider burden, and costs of unnecessary evaluation of enlarged nodes in the setting of recent vaccination, and 2) avoid further delays in vaccinations and breast cancer screening during the pandemic.

 

Related Medical Imaging of COVID Content:

COVID-19 Vaccination Axillary Adenopathy Detected During Breast Imaging

PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS) — Interview with Mike Stone, M.D.

VIDEO: Use of Teleradiology During the COVID-19 Pandemic — Interview with John Kim, M.D.

Find more radiology related COVID content 

 

Reference:

1. Constance D. Lehman, Leslie R. Lamb, and Helen Anne D'Alessandro. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach American Journal of Roentgenology. 10.2214/AJR.21.25688

 

 

Magnetic Resonance Imaging (MRI) | March 19, 2021

Darryl B. Sneag, M.D., a radiologist and director of peripheral nerve MRI at the Hospital for Special Surgery (HSS) in New York City, explains how artificial intelligence (AI) magnetic resonance imaging (MRI) reconstruction algorithms have cut imaging times by 50 percent. This has enabled his facility to maintain the same number of patients as it did prior to the pandemic, while still having time to sterilize the scanners after each patient. 

Many radiology departments are now experiencing a backlog of cases due to COVID-19 shutdowns in 2020 and the limits on the number of patients that can be in the hospital for imaging exams due to pandemic containment precautions. Sneag said AI is now playing a role in helping streamline workflow.

HSS has 19 GE Healthcare MRI scanners and uses the Air Recon DL AI image reconstruction algorithm. This allows for shorter scan times, so the same number of patients as pre-pandemic can be imaged per day, even with deeper cleaning of the MRI bore. Sneag explains the algorithm has greatly helped with patient throughput, but the trade off is sometimes getting a ringing artifact on images.

HSS also uses GE's Air Coil flexible pad MRI coils. These can wrap around the patient to improve comfort and get the coils closer to the anatomy being imaged.

 

Related MRI and COVID Content:

Business During COVID-19 and Beyond

Imaging Volumes Hold Steady Post COVID-19 Closures

GE Healthcare Addresses Growing Radiology Data Challenges at RSNA 2019

Technology is Driving the MRI Market

VIDEO: How to Image COVID-19 and Radiological Presentations of the Virus

Top Trend Takeaways in Radiology From RSNA 2020

Post-COVID Pain or Weakness? Request an Ultrasound or MRI

Find more COVID radiology-related content

 

Sponsored Videos View all 162 items

Information Technology | December 01, 2020

Treating cancer effectively often includes a combination of patient therapies. In recent years, technology advancements have led to a more efficient and personalized approach to treatment. Andrew Wilson, President of Oncology Informatics at Elekta, discussed the latest software advancements with ITN.

X-Ray | November 28, 2020

Agfa is looking to transform X-ray with new advancements in volumetric imaging, and with new mobile concepts and implementation of intelligent tools. ITN had a conversation with Georges Espada on Transforming X-ray with Intelligent Tools.

Enterprise Imaging | November 23, 2020

Fujifilm's next generation secure server-side viewer platform extends across enterprise imaging areas to bring together radiology, mammography and cardiology into a single zero footprint platform. Bill Lacy, vice president of medical informatics for Fujifilm Medical Systems USA recently talked with ITN about their Synapse 7x platform.

PACS | June 29, 2020

Kevin Borden, Vice President of Product, Healthcare IT for Konica Minolta, talks about Improving Access and Aiding Workflow with itnTV. He explains how the server-side rendering and zero-footprint viewer in its Exa PACS make it well-suited for remote reading.

Technology Reports View all 11 items

Artificial Intelligence | February 21, 2020

In Artificial Intelligence at RSNA 2019, ITN Contributing Editor Greg Freiherr offers an overview of artificial intelligence (AI) advances at the Radiological Society of North America (RSNA) 2019 annual meeting.

Enterprise Imaging | February 21, 2020

In Enterprise Imaging at RSNA 2019, ITN Contributing Editor Greg Freiherr offers an overview of enterprise imaging advances at the Radiological Society of North America (RSNA) 2019 annual meeting.

Conference Coverage View all 467 items

Coronavirus (COVID-19) | January 26, 2021

This is an example of a COVID-19 (SARS-CoV-2) positive patient's lung computed tomography (CT) scan. The video scrolls through the image slices of the scan and shows the typical white, ground glass opacities (GGO) caused by COVID pneumonia. The pneumonia typically appears along the walls of each lobe of the lung, especially the chest wall and the lower portions of the lungs. This scan is from a Canon Aquilion Prime SP CT scanner and used Advanced intelligent Clear-IQ Engine (AiCE), an artificial intelligence-driven image reconstruction software to improve image quality of lower-dose scans. This was shown by Canon Medical as an exmaple of CT image quality for the virus at the 2020 Radiological Society of North American (RSNA) meeting. 

Read more about this system and its launch in 2020 to address COVID, Canon Medical Launches CT Solution for Patients with Viral Infectious Diseases.

VIDEO: How to Image COVID-19 and Radiological Presentations of the Virus interview with Margarita Revzin, M.D., associate professor of radiology and biomedical imaging, Yale School of Medicine.

Find more radiology clinical images of coronavirus in this photo gallery.

Find more radiology related COVID news and video

Artificial Intelligence | December 02, 2020

Kirti Magudia, M.D., Ph.D., an abdominal imaging and ultrasound fellow at the University of California San Francisco, explains how an automated deep learning analysis of abdominal computed tomography (CT) images can produce a more precise measurement of body composition and better predicts major cardiovascular events, such as heart attack and stroke, better than overall weight or body mass index (BMI). This was according to a study she presented at the 2020 Radiological Society of North America (RSNA) virtual meeting.

Unlike BMI, which is based on height and weight, a single axial CT slice of the abdomen visualizes the volume of subcutaneous fat area, visceral fat area and skeletal muscle area. However, manually measuring these individual areas is time intensive and costly. A multidisciplinary team of researchers, including radiologists, a data scientist and biostatistician, developed a fully automated artificial intelligence (AI) method to determine body composition metrics from abdominal CT images.

Statistical analysis demonstrated that visceral fat area was independently associated with future heart attack and stroke. BMI was not associated with heart attack or stroke.

Read more about this study

Find more RSNA news

Information Technology | December 01, 2020

Treating cancer effectively often includes a combination of patient therapies. In recent years, technology advancements have led to a more efficient and personalized approach to treatment. Andrew Wilson, President of Oncology Informatics at Elekta, discussed the latest software advancements with ITN.

Remote Viewing Systems | November 28, 2020

Konica Minolta’s theme for RSNA 2020 is Depth of Vision. ITN recently talked with David Widmann, President and CEO of Konica Minolta Healthcare Americas, about this focus and their key messages for customers and RSNA attendees.

Radiation Oncology View all 116 items

Information Technology | December 01, 2020

Treating cancer effectively often includes a combination of patient therapies. In recent years, technology advancements have led to a more efficient and personalized approach to treatment. Andrew Wilson, President of Oncology Informatics at Elekta, discussed the latest software advancements with ITN.

Radiation Therapy | November 15, 2020

Bruce Bauer, Ph.D., CEO of TAE Life Sciences. The company is developing boron neutron capture therapy (BNCT) as a new radiation therapy for cancer. A patient is first infused with a non-toxic boron-10 compound, which selectively accumulates in tumor tissue. A neutron beam is then focused on the tumor and the neutrons are captured by the boron and causes emission of alpha radiation particles within the tumor. Alpha particles have a a very short range, so this helps spare surrounding healthy tissue from radiation damage. 

Historically, BNCT clinical studies have been carried out using boronophenylalanine (BPA) and neutrons derived from the core of a nuclear reactor. While the clinical outcomes have been encouraging, the availability of better boron-10 compounds and access to a neutron source posed a significant barrier to clinical research and adoption of BNCT as a practical cancer therapy.

There is now a renaissance in BNCT with the availability of new accelerator-based neutrons sources and novel synthesis of boron-10 target drugs, allowing clinical research to expand with the goal to have BNCT available as a new treatment option for patients.

The secondary radiation reaction from BNCT, with cellular-level precision, spares more healthy tissues and can potentially treat cancers that otherwise have few treatment options.

The system requires a neutron accelerator, but this is smaller than a proton system and operates at much lower energy, so the shielding requirement is much lower, cutting construction costs.

Find more news and video on radiation therapy

 

Contrast Media Injectors | May 22, 2020

At this year’s RSNA ITN sat down with Dennis Durmis, Senior Vice President, Bayer Radiology to discuss Radiology trends. Discussion topics centered around three key areas where Bayer Radiology is responding to trends; including digitalization, workflow efficiencies and efforts to bring more focus to the Radiology patient experience. During the interview Dennis discussed Bayer’s digital strategy, features and benefits of their new injector, the MEDRAD® Stellant FLEX Injector and Bayer’s education efforts of the imaging needs of women with Dense Breast.

Artificial Intelligence | February 21, 2020

In Artificial Intelligence at RSNA 2019, ITN Contributing Editor Greg Freiherr offers an overview of artificial intelligence (AI) advances at the Radiological Society of North America (RSNA) 2019 annual meeting.

Radiology Imaging View all 361 items

Coronavirus (COVID-19) | May 11, 2021

Yael Eshet, M.D., MSc, a diagnostic radiology specialist at Sheba Medical Center in Israel, was the lead author on a recent study that showed COVID-19 (SARS-CoV-2) vaccine adenopathy can persist more than 6 weeks. This swelling of lymph nodes is similar to what is seen cancer and infections and the new findings show it can last longer than 7-10 weeks. The current recommended time people should delay medical imaging is 6 weeks after receiving a COVID vaccine to avoid a misdiagnosis,[2] but this new study shows there is increased inflammation shown on PET-CT imaging for much longer.

These were the findings in the Radiology published study "Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination."[1]

Researchers using fluorodeoxyglucose (FDG)-positron emission tomography (PET) have found increased FDG uptake in the lymph nodes of patients 7-10 weeks past their second mRNA-based Pfizer-BioNTech COVID-19 vaccination. This new information indicates a persistent immune response that could be mistaken on imaging exams for serious conditions like lymphoma over a much longer period of time.

Recent recommendations for post-vaccine lymphadenopathy advise scheduling routine imaging, such as screening mammography, before, or at least 6 weeks after, the final vaccination dose to eliminate false positive results. However, this new research showed that avid axillary lymph node uptake was present beyond 6 weeks after the second vaccination in more than 29% of the patients in the study cohort.

The authors stated “This study shows that avid axillary lymph node uptake on FDG PET/CT can be detected in more than a quarter of our patient population even beyond 6 weeks after the second dose of the mRNA-based COVID-19 vaccination. Compared to a previous study showing normalization of FDG uptake within 40 days of receiving an inactivated H1N1 influenza vaccine, we found uptake persistence even at 70 days. Physicians should be aware of this potential pitfall.”

Some images in this video are from another Radiology study, which showed PET tracer uptake at the COVID vaccine injection site and other examples of axillary adenopathy.[3]

 

Related COVID Vaccine Axillary Adenapathy Content:

COVID-19 Vaccine Can Cause False Positive Cancer Diagnosis

Help Spread Awareness of Potential COVID-19 Vaccine Imaging Side-effects

VIDEO: COVID Vaccine May Cause Enlarged Lymph Nodes on Mammograms — Interview with Constance "Connie" Lehman, M.D.

COVID-19 Vaccination Axillary Adenopathy Detected During Breast Imaging

PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

Find more radiology related COVID content 

References:

1. Yael Eshet, Noam Tau1, Yousef Alhoubani, Nayroz Kanana, Liran Domachevsky, Michal Eifer. Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination. Radiology. Published Online:Apr 27 2021https://doi.org/10.1148/radiol.2021210886.

2. Constance D. Lehman, Leslie R. Lamb, and Helen Anne D'Alessandro. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach American Journal of Roentgenology. 10.2214/AJR.21.25688.

3. Can Özütemiz, Luke A. Krystosek, An L. Church, Anil Chauhan, Jutta M. Ellermann, Evidio Domingo-Musibay, Daniel Steinberger. Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncology Patients. Radiology. Published Online:Feb 24 2021https://doi.org/10.1148/radiol.2021210275.

 

Point-of-Care Ultrasound (POCUS) | April 01, 2021

Here are two quick clinical examples of point-of-care ultrasound (POCUS) lung imaging and cardiac imaging using a GE Vscan Air device. The examples show an abnormal lung image with B-lines. The second clip shows a healthy heart in a parasternal color Doppler image.

The GE Healthcare Vscan Air is a cutting-edge, wireless pocket-sized ultrasound that provides crystal clear image quality, whole-body scanning capabilities, and intuitive software. The pocket-sized ultrasound system was originally introduced in 2010, and as of early 2021, there are over 30,000 Vscan systems in use. The new Vscan Air features a wireless ultrasound probe.

Read more in the article GE Healthcare Unveils Vscan Air Wireless Handheld Ultrasound

Find more POCUS news and video

Breast Imaging | March 26, 2021

Constance "Connie" Lehman, M.D., Ph.D., chief of breast imaging, co-director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital, and professor of radiology at Harvard Medical School, explains issues and suggested guidelines for women who receive the COVID-19 vaccine and need to get a mammogram. In the first three months since the vaccines have been released, there have been numerous case reports of the vaccine causing swollen lymph nodes. This is would usually raise a red flag for breast cancer, but is normal for many women receiving the vaccine as their body's immune system gears up against the virus. 

Lehman said cases reports of axillary adenopathy have been identified on breast imaging after coronavirus disease (COVID-19) vaccination and are rising. Lehman et al. proposed a pragmatic management approach in a recent article in the American Journal of Roentgenology (AJR).[1]

In the settings of screening mammography, screening MRI and diagnostic imaging work-up of breast symptoms, with no imaging findings beyond unilateral axillary adenopathy ipsilateral to recent (prior six weeks) vaccination, they report the adenopathy as benign with no further imaging indicated if no nodes are palpable six weeks after the last vaccine dose. 

For patients with palpable axillary adenopathy in the setting of ipsilateral recent vaccination, clinical follow-up of the axilla is recommended. In all these scenarios, axillary ultrasound is recommended if clinical concern persists six weeks after vaccination. 

In patients with recent breast cancer diagnosis in the pre- or peri-treatment setting, prompt recommended imaging is encouraged as well as vaccination (in the thigh or contralateral arm). The recommendations align with the ACR BI-RADS Atlas and aim to: 1) reduce patient anxiety, provider burden, and costs of unnecessary evaluation of enlarged nodes in the setting of recent vaccination, and 2) avoid further delays in vaccinations and breast cancer screening during the pandemic.

 

Related Medical Imaging of COVID Content:

COVID-19 Vaccination Axillary Adenopathy Detected During Breast Imaging

PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS) — Interview with Mike Stone, M.D.

VIDEO: Use of Teleradiology During the COVID-19 Pandemic — Interview with John Kim, M.D.

Find more radiology related COVID content 

 

Reference:

1. Constance D. Lehman, Leslie R. Lamb, and Helen Anne D'Alessandro. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach American Journal of Roentgenology. 10.2214/AJR.21.25688

 

 

Magnetic Resonance Imaging (MRI) | March 19, 2021

Darryl B. Sneag, M.D., a radiologist and director of peripheral nerve MRI at the Hospital for Special Surgery (HSS) in New York City, explains how artificial intelligence (AI) magnetic resonance imaging (MRI) reconstruction algorithms have cut imaging times by 50 percent. This has enabled his facility to maintain the same number of patients as it did prior to the pandemic, while still having time to sterilize the scanners after each patient. 

Many radiology departments are now experiencing a backlog of cases due to COVID-19 shutdowns in 2020 and the limits on the number of patients that can be in the hospital for imaging exams due to pandemic containment precautions. Sneag said AI is now playing a role in helping streamline workflow.

HSS has 19 GE Healthcare MRI scanners and uses the Air Recon DL AI image reconstruction algorithm. This allows for shorter scan times, so the same number of patients as pre-pandemic can be imaged per day, even with deeper cleaning of the MRI bore. Sneag explains the algorithm has greatly helped with patient throughput, but the trade off is sometimes getting a ringing artifact on images.

HSS also uses GE's Air Coil flexible pad MRI coils. These can wrap around the patient to improve comfort and get the coils closer to the anatomy being imaged.

 

Related MRI and COVID Content:

Business During COVID-19 and Beyond

Imaging Volumes Hold Steady Post COVID-19 Closures

GE Healthcare Addresses Growing Radiology Data Challenges at RSNA 2019

Technology is Driving the MRI Market

VIDEO: How to Image COVID-19 and Radiological Presentations of the Virus

Top Trend Takeaways in Radiology From RSNA 2020

Post-COVID Pain or Weakness? Request an Ultrasound or MRI

Find more COVID radiology-related content

 

Molecular Imaging View all 30 items

Coronavirus (COVID-19) | May 11, 2021

Yael Eshet, M.D., MSc, a diagnostic radiology specialist at Sheba Medical Center in Israel, was the lead author on a recent study that showed COVID-19 (SARS-CoV-2) vaccine adenopathy can persist more than 6 weeks. This swelling of lymph nodes is similar to what is seen cancer and infections and the new findings show it can last longer than 7-10 weeks. The current recommended time people should delay medical imaging is 6 weeks after receiving a COVID vaccine to avoid a misdiagnosis,[2] but this new study shows there is increased inflammation shown on PET-CT imaging for much longer.

These were the findings in the Radiology published study "Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination."[1]

Researchers using fluorodeoxyglucose (FDG)-positron emission tomography (PET) have found increased FDG uptake in the lymph nodes of patients 7-10 weeks past their second mRNA-based Pfizer-BioNTech COVID-19 vaccination. This new information indicates a persistent immune response that could be mistaken on imaging exams for serious conditions like lymphoma over a much longer period of time.

Recent recommendations for post-vaccine lymphadenopathy advise scheduling routine imaging, such as screening mammography, before, or at least 6 weeks after, the final vaccination dose to eliminate false positive results. However, this new research showed that avid axillary lymph node uptake was present beyond 6 weeks after the second vaccination in more than 29% of the patients in the study cohort.

The authors stated “This study shows that avid axillary lymph node uptake on FDG PET/CT can be detected in more than a quarter of our patient population even beyond 6 weeks after the second dose of the mRNA-based COVID-19 vaccination. Compared to a previous study showing normalization of FDG uptake within 40 days of receiving an inactivated H1N1 influenza vaccine, we found uptake persistence even at 70 days. Physicians should be aware of this potential pitfall.”

Some images in this video are from another Radiology study, which showed PET tracer uptake at the COVID vaccine injection site and other examples of axillary adenopathy.[3]

 

Related COVID Vaccine Axillary Adenapathy Content:

COVID-19 Vaccine Can Cause False Positive Cancer Diagnosis

Help Spread Awareness of Potential COVID-19 Vaccine Imaging Side-effects

VIDEO: COVID Vaccine May Cause Enlarged Lymph Nodes on Mammograms — Interview with Constance "Connie" Lehman, M.D.

COVID-19 Vaccination Axillary Adenopathy Detected During Breast Imaging

PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

Find more radiology related COVID content 

References:

1. Yael Eshet, Noam Tau1, Yousef Alhoubani, Nayroz Kanana, Liran Domachevsky, Michal Eifer. Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination. Radiology. Published Online:Apr 27 2021https://doi.org/10.1148/radiol.2021210886.

2. Constance D. Lehman, Leslie R. Lamb, and Helen Anne D'Alessandro. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach American Journal of Roentgenology. 10.2214/AJR.21.25688.

3. Can Özütemiz, Luke A. Krystosek, An L. Church, Anil Chauhan, Jutta M. Ellermann, Evidio Domingo-Musibay, Daniel Steinberger. Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncology Patients. Radiology. Published Online:Feb 24 2021https://doi.org/10.1148/radiol.2021210275.

 

PET-CT | December 04, 2020

This is an example of Canon's Advanced intelligent Clear-IQ Engine (AiCE) AI-driven image reconstruction software that is now being used to improve image quality on the Canon Celesteion Prime PET/CT nuclear imaging system. The deep learning is used to enhance the iterative reconstruction used to reduce noise and sharped high contrast resolution on positron emission tomography (PET) images from the digital PET detector used on the system. 

This example is a whole-body FGD PET scan of a patient with a large BMI with lung cancer.

The Cartesion Prime PET/CT is the industry’s only air-cooled digital PET/CT, provides variable bed time (vBT) acquisition as a standard feature. This and the new FDA 510(k)-pending AiCE technology were highlighted at the 2020 Radiological Society of North America (RSNA) virtual meeting. 

Find more RSNA news

 

Artificial Intelligence | September 25, 2020

Ernest Garcia, Ph.D., MASNC, FAHA, endowed professor in cardiac imaging, director of nuclear cardiology R&D laboratory, Emory University, developer of the Emory Cardiac Tool Box used in nuclear imaging and past-president of the American Society of Nuclear Cardiology (ASNC), explains the use of artificial intelligence (AI) in cardiac imaging. He said there is a tsunami of new AI applications that are starting to flood the FDA for market approval, and there are several examples of AI already in use in radiology. He spoke on this topic in a keynote session at the 2020 ASNC meeting.

 

Related Artificial Intelligence in Cardiology Content:

VIDEO: Machine Learning for Diagnosis and Risk Prediction in Nuclear Cardiology — Interview with Piotr J. Slomka, Ph.D.,

Artificial Intelligence Applications in Cardiology

VIDEO: Artificial Intelligence May Improve Cath Lab Interventions — Interview with Nick West, M.D., Abbott CMO

How Artificial Intelligence Will Change Medical Imaging

VIDEO: Artificial Intelligence for Echocardiography at Mass General — Interview with Judy Hung, M.D.

VIDEO: ACC Efforts to Advance Evidence-based Implementation of AI in Cardiovascular Care — Interview with John Rumsfeld, M.D.

VIDEO: Overview of Artificial Intelligence and its Use in Cardiology — Interview with Anthony Chang, M.D.

For more AI in cardiology content

Coronavirus (COVID-19) | April 18, 2020

Stephen Bloom, M.D., FASNC, director of noninvasive cardiology (cardiac CT, nuclear cardiology and echocardiography) at Midwest Heart and Vascular Associates, Overland Park, Kansas. He is also a member of the American Society of Nuclear Cardiology (ASNC) Board of Directors, explains some of the issues involved and protocols used for cardiac imaging during the COVID-19 pandemic. His discussion includes computed tomography, cardiac ultrasound and nuclear imaging.

Right now, Bloom said it is difficult to test everybody and there is a shortage of masks, gowns and other personal protective equipment (PPE), and the imaging equipment needs to be sanitized each time it is used. He said it is just is not possible to image all the patients who need imaging right now. Hospitals also are trying to limit the number of healthy people people coming into hospitals for routine visits and tests to reduce their potential exposure to the novel coronavirus (COVID-19, SARS-CoV-2) and help containment efforts. 

"The tests should be done, very simply, if it changes the care of the patient. If it doesn't change the care of the patient, and it can be postponed, it should be postponed," Bloom explained. "I would say 80 percent of our cardiac imaging exams have stopped. It has been very dramatic."

 

Related Imaging Precautions During COVID-19 Content:

Cardiac Imaging Best Practices During the COVID-19 Pandemic

Best Practices for Nuclear Cardiology Laboratories During the Coronavirus (COVID-19) Pandemic

ASE Guidelines for the Protection of Echocardiography Providers During the COVID-19 Outbreak 

VIDEO: Best Practices for Nuclear Cardiology During the COVID-19 Pandemic — Interview with Hicham Skali, M.D.

VIDEO: Cancelling Non-essential Cardiac Procedures During the COVID-19 Outbreak — Interview with Ehtisham Mahmud, M.D. 

VIDEO: 9 Cardiologists Share COVID-19 Takeaways From Across the U.S.  

VIDEO: Telemedicine in Cardiology and Medical Imaging During COVID-19 — Interview with Regina Druz, M.D.

VIDEO: Use of Teleradiology During the COVID-19 Pandemic — an interview with radiologist John Kim, M.D.

Study Looks at CT Findings of COVID-19 Through Recovery

Experts Stress Radiology Preparedness for COVID-19

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS) — Interview with emergency physician Mike Stone, M.D.,

VIDEO: How China Leveraged Health IT to Combat COVID-19 — Interview with Jilan Liu, M.D., CEO for the HIMSS Greater China

ACR Recommendations for the Use of Chest Radiography and CT for Suspected COVID-19 Cases

VIDEO: What Cardiologists Need to Know about COVID-19 — Interview with Thomas Maddox, M.D.

The Cardiac Implications of Novel Coronavirus

Information Technology View all 263 items

Magnetic Resonance Imaging (MRI) | March 19, 2021

Darryl B. Sneag, M.D., a radiologist and director of peripheral nerve MRI at the Hospital for Special Surgery (HSS) in New York City, explains how artificial intelligence (AI) magnetic resonance imaging (MRI) reconstruction algorithms have cut imaging times by 50 percent. This has enabled his facility to maintain the same number of patients as it did prior to the pandemic, while still having time to sterilize the scanners after each patient. 

Many radiology departments are now experiencing a backlog of cases due to COVID-19 shutdowns in 2020 and the limits on the number of patients that can be in the hospital for imaging exams due to pandemic containment precautions. Sneag said AI is now playing a role in helping streamline workflow.

HSS has 19 GE Healthcare MRI scanners and uses the Air Recon DL AI image reconstruction algorithm. This allows for shorter scan times, so the same number of patients as pre-pandemic can be imaged per day, even with deeper cleaning of the MRI bore. Sneag explains the algorithm has greatly helped with patient throughput, but the trade off is sometimes getting a ringing artifact on images.

HSS also uses GE's Air Coil flexible pad MRI coils. These can wrap around the patient to improve comfort and get the coils closer to the anatomy being imaged.

 

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PET-CT | December 04, 2020

This is an example of Canon's Advanced intelligent Clear-IQ Engine (AiCE) AI-driven image reconstruction software that is now being used to improve image quality on the Canon Celesteion Prime PET/CT nuclear imaging system. The deep learning is used to enhance the iterative reconstruction used to reduce noise and sharped high contrast resolution on positron emission tomography (PET) images from the digital PET detector used on the system. 

This example is a whole-body FGD PET scan of a patient with a large BMI with lung cancer.

The Cartesion Prime PET/CT is the industry’s only air-cooled digital PET/CT, provides variable bed time (vBT) acquisition as a standard feature. This and the new FDA 510(k)-pending AiCE technology were highlighted at the 2020 Radiological Society of North America (RSNA) virtual meeting. 

Find more RSNA news

 

Artificial Intelligence | December 02, 2020

Kirti Magudia, M.D., Ph.D., an abdominal imaging and ultrasound fellow at the University of California San Francisco, explains how an automated deep learning analysis of abdominal computed tomography (CT) images can produce a more precise measurement of body composition and better predicts major cardiovascular events, such as heart attack and stroke, better than overall weight or body mass index (BMI). This was according to a study she presented at the 2020 Radiological Society of North America (RSNA) virtual meeting.

Unlike BMI, which is based on height and weight, a single axial CT slice of the abdomen visualizes the volume of subcutaneous fat area, visceral fat area and skeletal muscle area. However, manually measuring these individual areas is time intensive and costly. A multidisciplinary team of researchers, including radiologists, a data scientist and biostatistician, developed a fully automated artificial intelligence (AI) method to determine body composition metrics from abdominal CT images.

Statistical analysis demonstrated that visceral fat area was independently associated with future heart attack and stroke. BMI was not associated with heart attack or stroke.

Read more about this study

Find more RSNA news

Information Technology | December 01, 2020

Treating cancer effectively often includes a combination of patient therapies. In recent years, technology advancements have led to a more efficient and personalized approach to treatment. Andrew Wilson, President of Oncology Informatics at Elekta, discussed the latest software advancements with ITN.

Women's Health View all 77 items

Coronavirus (COVID-19) | May 11, 2021

Yael Eshet, M.D., MSc, a diagnostic radiology specialist at Sheba Medical Center in Israel, was the lead author on a recent study that showed COVID-19 (SARS-CoV-2) vaccine adenopathy can persist more than 6 weeks. This swelling of lymph nodes is similar to what is seen cancer and infections and the new findings show it can last longer than 7-10 weeks. The current recommended time people should delay medical imaging is 6 weeks after receiving a COVID vaccine to avoid a misdiagnosis,[2] but this new study shows there is increased inflammation shown on PET-CT imaging for much longer.

These were the findings in the Radiology published study "Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination."[1]

Researchers using fluorodeoxyglucose (FDG)-positron emission tomography (PET) have found increased FDG uptake in the lymph nodes of patients 7-10 weeks past their second mRNA-based Pfizer-BioNTech COVID-19 vaccination. This new information indicates a persistent immune response that could be mistaken on imaging exams for serious conditions like lymphoma over a much longer period of time.

Recent recommendations for post-vaccine lymphadenopathy advise scheduling routine imaging, such as screening mammography, before, or at least 6 weeks after, the final vaccination dose to eliminate false positive results. However, this new research showed that avid axillary lymph node uptake was present beyond 6 weeks after the second vaccination in more than 29% of the patients in the study cohort.

The authors stated “This study shows that avid axillary lymph node uptake on FDG PET/CT can be detected in more than a quarter of our patient population even beyond 6 weeks after the second dose of the mRNA-based COVID-19 vaccination. Compared to a previous study showing normalization of FDG uptake within 40 days of receiving an inactivated H1N1 influenza vaccine, we found uptake persistence even at 70 days. Physicians should be aware of this potential pitfall.”

Some images in this video are from another Radiology study, which showed PET tracer uptake at the COVID vaccine injection site and other examples of axillary adenopathy.[3]

 

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References:

1. Yael Eshet, Noam Tau1, Yousef Alhoubani, Nayroz Kanana, Liran Domachevsky, Michal Eifer. Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination. Radiology. Published Online:Apr 27 2021https://doi.org/10.1148/radiol.2021210886.

2. Constance D. Lehman, Leslie R. Lamb, and Helen Anne D'Alessandro. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach American Journal of Roentgenology. 10.2214/AJR.21.25688.

3. Can Özütemiz, Luke A. Krystosek, An L. Church, Anil Chauhan, Jutta M. Ellermann, Evidio Domingo-Musibay, Daniel Steinberger. Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncology Patients. Radiology. Published Online:Feb 24 2021https://doi.org/10.1148/radiol.2021210275.

 

Breast Imaging | March 26, 2021

Constance "Connie" Lehman, M.D., Ph.D., chief of breast imaging, co-director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital, and professor of radiology at Harvard Medical School, explains issues and suggested guidelines for women who receive the COVID-19 vaccine and need to get a mammogram. In the first three months since the vaccines have been released, there have been numerous case reports of the vaccine causing swollen lymph nodes. This is would usually raise a red flag for breast cancer, but is normal for many women receiving the vaccine as their body's immune system gears up against the virus. 

Lehman said cases reports of axillary adenopathy have been identified on breast imaging after coronavirus disease (COVID-19) vaccination and are rising. Lehman et al. proposed a pragmatic management approach in a recent article in the American Journal of Roentgenology (AJR).[1]

In the settings of screening mammography, screening MRI and diagnostic imaging work-up of breast symptoms, with no imaging findings beyond unilateral axillary adenopathy ipsilateral to recent (prior six weeks) vaccination, they report the adenopathy as benign with no further imaging indicated if no nodes are palpable six weeks after the last vaccine dose. 

For patients with palpable axillary adenopathy in the setting of ipsilateral recent vaccination, clinical follow-up of the axilla is recommended. In all these scenarios, axillary ultrasound is recommended if clinical concern persists six weeks after vaccination. 

In patients with recent breast cancer diagnosis in the pre- or peri-treatment setting, prompt recommended imaging is encouraged as well as vaccination (in the thigh or contralateral arm). The recommendations align with the ACR BI-RADS Atlas and aim to: 1) reduce patient anxiety, provider burden, and costs of unnecessary evaluation of enlarged nodes in the setting of recent vaccination, and 2) avoid further delays in vaccinations and breast cancer screening during the pandemic.

 

Related Medical Imaging of COVID Content:

COVID-19 Vaccination Axillary Adenopathy Detected During Breast Imaging

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VIDEO: Use of Teleradiology During the COVID-19 Pandemic — Interview with John Kim, M.D.

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Reference:

1. Constance D. Lehman, Leslie R. Lamb, and Helen Anne D'Alessandro. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach American Journal of Roentgenology. 10.2214/AJR.21.25688

 

 

Artificial Intelligence | November 11, 2020

Artificial Intelligence (AI) is becoming more common place in radiology practices, and emerging technologies are providing radiologists with sophisticated detection software to aid their reading and provide support for a busy workflow. With the progression of AI technology, vendors must look not only at what AI can do for the radiologist, but how the radiologist and the technician interact with that technology –  the goal should be increasing accuracy while also positively improving workflow. GE Healthcare is working to improve radiology AI workflow in its Centricity Universal Viewer.

Three key opinion leaders offers their views on what is needed to make AI more valauble and accessible to radiologists. These include:

   • Amy Patel, M.D., breast radiologist, medical director, Liberty Hospital Women's Imaging, assistant professor of radiology, University of Missouri-Kansas City.

   • Prof. Dr. Thomas Frauenfelder, M.D., vice chairman and professor of thoracic radiology, Institute for Diagnostic and Interventional Radiology, University of Zurich.

   • Randy Hicks, M.D., chief executive officer, Regional Medical Imaging.

 

Learn more about the Centricity Universal Viewer in the VIDEO: How GE Healthcare’s Zero Footprint Remote Image Viewer Supports Clinical Care

 

 

 

 

 

MRI Breast | October 14, 2020

Professor Christiane Kuhl, M.D., director of radiology, University Hospital Aachen, Germany, explains how breast magnetic resonance imaging (MRI) can be used to clearly identify breast cancers in women with dense breast tissue. In women with dense breasts, it can be very difficult to detect many cancers on standard mammograms because the cancers and dense tissue both appear white. MRI can help clearly define tumors and identify which nodules are cancer and which are benign, which can help greatly reduce the need for biopsies.

Kuhl is an expert in breast imaging and breast MRI. She helped develop an a shortened MRI protocol that allows breast MR images to be created in 3 minutes or less, rather than standard protocols that can take up to 30 minutes. In the interview she shows patient case examples of standard mammograms and the MRI supplemental imaging for the same patient to show the hidden tumors. 

She also explains the differences between standard 2-d mammography, the current standard of care, and the newer 3-D mammogram tomosythnesis technology, breast ultrasound and breast MRI technologies.

Read the related article Use of Breast MRI Screening in Women With Dense Breasts, which includes case examples comparing mammograms to the patients' breast MRIs.

Other video interviews with Dr. Kuhl:

VIDEO: Explaining Dense Breasts

VIDEO: The Impact of COVID-19 on Breast Imaging

 

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