Redefining Radiology at RSNA 2021

At RSNA 2021, innovative medical imaging research and new technologies will make their debut. Explore highlights from this year’s annual meeting in these preview press releases. 

Breast MRI Shows IUDs Have Systemic Effects

Intrauterine contraceptive devices (IUDs) appear to have systemic effects on the body like those of hormone replacement therapy, according to a breast MRI study from RWTH Aachen University in Aachen, Germany. Levonorgestrel-releasing IUDs (LNG-IUDs) are used by tens of millions of women worldwide. They work by releasing a small amount of hormone into the uterus. Because the hormone is released directly into the uterus, the amount in the bloodstream is lower than with other hormonal methods. In theory, this limited area of release means that any side effects would be confined to the region around the IUD. However, emerging evidence suggests that LNG-IUDs can be associated with systemic side effects similar to those of systemic hormonal medication. Women with a hormonal IUD in place often show higher background parenchymal enhancement on contrast-enhanced breast MRI.

Multiple Concussions Can Disrupt Brain Connectivity in Teens

Adolescents and young adults with post-concussive symptoms who suffered three to five concussions showed disruption in the default mode network, according to a study from the University of Rochester Medical Center in Rochester, NY. Using resting-state functional MRI (fMRI), researchers evaluated the default mode network by identifying which areas of the brain activated during imaging. Compared to controls, the researchers found no difference in the connectivity in the default mode network in patients who had experienced one or two concussions. In patients who had three to five concussions, the maps detected a disruption in the default mode network.

Autism Changes Brain’s White Matter over Time

Researchers at Yale University analyzing specialized MRI exams found significant changes in the microstructure of the brain’s white matter in adolescents and young adults with autism spectrum disorder (ASD) compared to a control group, according to research from Yale University School of Medicine. The changes were most pronounced in the  region that facilitates communication between the two hemispheres of the brain. Researchers reviewed diffusion tensor imaging (DTI) brain scans from a large dataset of patients between the age of six months and 50 years. The key finding of the analysis was reduced fractional anisotropy within the anterior/middle tracts of the corpus callosum in adolescent and young adult ASD patients compared to individuals in the control group. Corresponding increases in ASD-related mean diffusivity and radial diffusivity were found in young adults.

Cooled RFA Relieves Pain after Knee Replacement

A minimally invasive ablation procedure offers long-term relief for patients who experience chronic and debilitating pain after knee replacement surgery, according to a study from Emory University School of Medicine in Atlanta. Cooled radiofrequency ablation (C-RFA) offers hope for patients following total knee arthroplasty. Following treatment on patients who were experiencing persistent chronic pain after total knee replacement, study results showed that the patients experienced, on average, a statistically significant improvement in quality of life. Both pain and stiffness scores improved dramatically. No major complications were encountered, and no patients required repeat treatment, surgical revision or other intervention.

COVID-19 Fallout May Lead to More Cancer Deaths

Significant decreases in CT imaging for cancer persisted even after the peak of the COVID-19 pandemic in 2020, delaying diagnosis and treatment and raising the possibility of more advanced cancers and poorer outcomes for patients in the future, according to a study from Massachusetts General Hospital (MGH) and Harvard Medical School in Boston. Numerous studies have shown COVID-19’s severe impact on U.S. health care, as the pandemic filled hospitals and reduced imaging capacity during its peak of March to early May 2020. Few studies, however, have explored the pandemic’s lingering effects on cancer imaging. For the new study, researchers compared cancer-related CT exams during three periods of 2020: the pre-COVID phase (January to mid-March), peak COVID (mid-March to May) and post-COVID peak (May to mid-November). They looked at CT volume and the type of care being delivered through imaging. As expected, CT volumes dropped significantly during the COVID peak. CT for cancer screening fell a whopping 82%, while CT for initial workup, active cancer and cancer surveillance also saw significant declines. Volumes for cancer screening and initial workup failed to recover in the post-COVID peak period, remaining down 11.7% and 20%, respectively, from their pre-COVID numbers.

Visit RSNA.org/Press21 for additional press releases from RSNA 2021.