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    December 01, 2013

    The following are highlights from the current issues of RSNA’s two peer-reviewed journals.

    The characteristic pathologic features of Alzheimer disease (AD)
    (Click to enlarge) The characteristic pathologic features of Alzheimer disease (AD) originally described by (A) Alois Alzheimer; (1864–1915) in 1907, still considered essential for neuropathologic diagnosis; (B) senile plaques and (C) neurofibrillary tangles. (B) Note typical appearance of neocortical plaques with staining (hematoxylin-eosin stain; original magnification, 3200), and increased cellularity around the plaques, which consists primarily of reactive astrocytes. (C) Note typical appearance of a neurofibrillary tangle in a pyramidal neuron of the hippocampus (hematoxylin-eosin stain; original magnification, 3600). The tangle (arrow) appears as a circumscribed inclusion that extends from the cell body into the apical dendrite. (Reprinted, with permission, from reference 101.).
    (Radiology 2013;269;3:671–691) ©RSNA, 2013. All rights reserved. Printed with permission. 

    Neuroimaging and the Search for a Cure for Alzheimer Disease

    Biomarkers and neuroimaging have great potential to increase the power of clinical trials for Alzheimer disease (AD) through greater effect by matching imaging methodology with therapeutic mechanism.

    Radiologists can play a role in biomarker development, treatment monitoring in clinical trials and ultimately, in development of accurate diagnostic tests for patient care, according to a study in the December issue of Radiology (RSNA.org/Radiology) led by Jeffrey Petrella, M.D., of Duke University Medical Center, Durham, N.C. Researchers describe the progress made toward developing treatments designed to significantly slow or halt the progression of AD as well as a means of early identification of patients who may be candidates for such interventions. The authors also discuss:

    • The multinational Alzheimer’s Disease Neuroimaging Initiative (ADNI)
    • Biomarkers and clinical trials of AD therapeutics
    • Radiologists’ role in clinical care and trials
    • Beyond clinical care and trials: uncovering the pathophysiology of AD and other dementias

    “In addition to a critical role in trials, structural, molecular, and functional imaging techniques can give us a window on the etiology of AD and other neurodegenerative diseases,” the authors write. “This combination of developments has potential to bring diagnostic radiology to the forefront in AD research, therapeutic trials, and patient care.”

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available online only. 
     Engorged vasa recta
    (Click to enlarge) Engorged vasa recta coursing perpendicular to the imaging plane. Axial CT enterographic image in a 16-year-old boy with Crohn disease shows the vasa recta to be increased in size and number, giving the appearance of multiple dots (arrows). Segments of bowel with mucosal hyperenhancement, mural stratification, and bowel wall thickening are also seen.
    (RadioGraphics 2013;33;7: 1843–1863) ©RSNA, 2013. All rights reserved. Printed with permission.  

    CT and MR Enterography in Children and Adolescents with Inflammatory Bowel Disease

    Although CT enterography and MR enterography have become the imaging modalities of choice for inflammatory bowel disease (IBD), each has advantages and disadvantages in terms of diagnosing pediatric IBD.

    In an article in the November-December issue of RadioGraphics (RSNA.org/RadioGraphics), Alexander J. Towbin, M.D., of Cincinnati Children’s Hospital Medical Center, and colleagues discuss the use of CT enterography and MR enterography in the context of pediatric IBD in terms of advantages and disadvantages, protocol and imaging findings.

    Although CT enterography has many advantages over other radiologic and endoscopic modalities, its main disadvantage is its reliance on ionizing radiation. This has limited its use and has helped MR enterography become the primary method of evaluating the pediatric bowel. In addition to being radiation free, MR enterography can help evaluate peristalsis, has high contrast resolution and allows the use of diffusion-weighted imaging.

    CT enterography and MR enterography are similar imaging tests, each capable of helping identify IBD in a sensitive and specific manner, according to the authors.

    “We have been able to perform CT enterography and MR enterography reliably in children as young as 2 years of age,” the authors write. “Because the findings of pediatric IBD mirror those of adult disease in many ways, radiologists are able to interpret intestinal and extraintestinal findings in a wide range of patients.”

    This study features an Invited Commentary by Jonathan R. Dillman, M.D., University of Michigan Health System, C.S. Mott Children’s Hospital, Ann Arbor. 

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