Cardiovascular disease as assessed with whole-body MR imaging confers strong prognostic information in patients with diabetes mellitus (DM), according to new research.
Fabian Bamberg, M.D., Ph.D., of Ludwig Maximilians University, Munich, Germany, and colleagues studied the predictive value of whole-body MR imaging for the occurrence of a major adverse cardiac and cerebrovascular event (MACCE) in 65 patients with diabetes. The patients underwent a contrast-enhanced whole-body MR imaging protocol, including brain, cardiac and vascular sequences. Researchers then conducted follow-up inquiries to assess the rate of MACCE in the study group.
Follow-up was completed in 61 patients. After a median of 5.8 years, 14 patients experienced MACCE. Patients who had detectable vascular changes on whole-body MR imaging faced a cumulative MACCE risk rate of 20 percent at three years and 35 percent at six years. None of the patients with a normal whole-body MR imaging went on to experience MACCE.
“The extent of cardiovascular disease as detected with whole-body MR imaging in patients with diabetes mellitus (DM) has strong prognostic implications, independent of other established clinical or laboratory markers,” the authors write.
MR images of the knee from patients self-referred by clinicians who owned MR equipment are more likely to be negative than those from patients referred by clinicians without financial interest in the MR equipment, new research shows.
Matthew P. Lungren, M.D., of Duke University Medical Center, Durham, N.C., conducted a retrospective review of consecutive diagnostic MR images of the knee interpreted by one radiology practice between January and April 2009. The study comprised patients who had been referred by two separate physician groups serving the same geographic community: one with financial interest (FI) in the MR imaging equipment used and one with no financial interest (NFI) in the MR imaging equipment used.
Of 700 examinations, 205 had negative results (117 of 350 in the FI group and 88 of 350 in the NFI group, P = .016), a 33 percent increase in the frequency of studies with negative findings in patients referred by the physician group that owns the MR imaging equipment. Among examinations with positive results, the mean total number of positive abnormality subtypes per image did not significantly differ between groups: 1.52 for the FI group and 1.53 for the NFI group (P = .96).
“These findings suggest that there is a different threshold for ordering MR imaging examinations, which may be due to financial incentive,” the authors write.
Statewide collaborations like the California Breast Density Information Group (CBDIG) can assist in developing broad-scope guidelines and educational materials to help navigate challenges posed by breast density notification laws, according to a special report.
In California, legislation requiring notification of women with heterogeneously and extremely dense breast tissue took effect April 1, 2013. Elissa R. Price, M.D., of the University of California, San Francisco, and CBDIG colleagues identified key elements and implications of the law, researching scientific evidence needed to develop a robust response. The group developed educational materials for referring physicians and patients and constructed an easily accessible website containing information about breast density, breast cancer risk assessment and supplementary imaging.
In this era of patient-centered care and personalized medicine, breast density notification legislation provides an opportunity for radiologists to engage with referring clinicians and patients, the report states.
“The multi-institutional, multidisciplinary CBDIG approach may be a method for organizations to frame responses to individual state laws as similar legislation is passed across the United States,” the authors write.
See a feature article further examining what new breast density legislation means for radiologists and patients here.
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RadiologyInfo.org, the RSNA-ACR public information website, is pleased to announce its new Screening and Wellness section designed to answer patient questions about and provide a better understanding of:
Screening topics now available include Lung Cancer, Breast Cancer and Colorectal Cancer. Other topics in the works include cardiac and carotid artery screening.
In December, RSNA’s 60 Second Checkup radio program focuses on the potential of MR imaging to predict heart attack and stroke risk in people with diabetes.
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