Digital Radiography News

Intensive Radiotherapy Holds More Benefits for Localized Prostate Cancer…

According to a study spanning 10 years, a radiotherapy treatment plan involving higher doses of radiation is regarded as a much better option as opposed to lowering doses for men with localized prostate cancer. Having 37 sessions, or fractions, of radiotherapy at 74 Gray (Gy) as opposed to 32 fractions at 64 Gy, controlled the disease more efficiently and diminished the chance that men would require follow-up hormone-deprivation therapy, which can lead to long-term side-effects. The study’s findings, published in The Lancet Oncology, come from the major RT01 phase III trial. The trial was led by Professor Dearnaley at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust, and was funded and conducted by the Medical Research Council Clinical Trials Unit at UCL. The study also featured several leading clinical research centers in the UK, New Zealand, and Australia. In addition, the study exhibited the overall efficiency of radiotherapy for men with localized disease. Around three quarters of men treated with either the more or less intensive radiotherapy treatment plans were still alive after 10 years. Established in 1998, the trial divided 843 men with localized prostate cancer into two groups to contrast the two doses of radiotherapy. Some 421 men had the less and 422 the more intensive treatment plans. Both cohorts also had standard hormone-deprivation treatment concurrently with their radiotherapy. The five-year results of the trial have previously demonstrated the benefits of dose-escalated radiotherapy, and served as an influential role in changing NICE guidance to recommend it in prostate cancer. Dose escalation is now the standard for localized prostate cancer in the UK. The new 10-year results further fortify the evidence for selecting higher does radiotherapy, in addition to showing the long-term benefits of the treatment. Following 10 years, 55 per cent of men on the 37-fraction regime, when juxtaposed with 43 per cent of men on the 32-fraction regime, had survived without their cancer progressing into a more perilous form, as measured by the standard prostate-specific antigen (PSA) test. In each half of the study, 71 per cent of men were alive following 10 years, with only 11 per cent dying from prostate cancer. Men who were administered the higher dose were more likely to have side-effects connected with radiotherapy, but few men had severe side-effects. Receiving the higher dose reduced the need for follow-up hormone treatment, which also has its own risk of side-effects. The trial did not reveal that men given dose-escalated radiotherapy live longer, however both cohorts of men lived much longer than expected. Almost three quarters of all the men in the study were still alive after 10 years, and of the 236 men who had died since treatment, only 91 had died of prostate cancer. "Our study has proved that treating men with localized prostate cancer using higher doses of radiotherapy is more effective than a less intensive regime. The dose-escalated regime is safe in the long term, and reduces the chances that a cancer will return and men will require further hormone-deprivation treatment. The side-effects of hormone treatment do need to be balanced against those of the extra radiotherapy doses, but overall our study has shown men are better off after having the escalated regime, as is now the norm in the UK,” said Study leader Professor David Dearnaley, Professor of Uro-Oncology at The Institute of Cancer Research, London, and Honorary Consultant at the Royal Marsden NHS Foundation Trust. "Another key finding to come out of our study is that radiotherapy in general is both a safe and an effective treatment for localized prostate cancer. Almost three quarters of men treated with either the more or less intensive radiotherapy regimes are still alive after 10 years, and of the men who have died, less than half actually died from prostate cancer. Further refinements in radiotherapy techniques since our trial began have made treatment even safer and are very important as men with localized prostate cancer have such favorable long-term survival prospects,” he added. Senior Scientist and Statistician at the MRC Clinical Trials Unit at UCL, Matthew Sydes said: "The RT01 trial has already changed how men with localized prostate cancer are treated. The current NICE guidelines recommend the use of the higher dose of radiotherapy, based on the five-year results of RT01. The trial also helped to develop guidelines on how to limit the radiation that organs near the tumor receive, and helped hospitals across the UK to introduce quality-assured conformal radiotherapy. It is now contributing to biological studies to help better understand the disease and the side-effects of ... Read more

Cancer Patients Demand More Written Information …

Based on a new study, patients who receive radiotherapy for pelvic cancers demand to be better informed regarding the numerous side effects prior to treatment. Around half of the patients who participated in a UK survey reported unfulfilled information needs on a variety of issues, including rehabilitation, ways to access supportive services, and how to cope with the treatment's sexual consequences. Over two thirds of the 58 patients said they were given written information, mostly by a nurse, and this was, for the most part, well received. None of the respondents requested less information. The authors of the study, published in Cancer Nursing Practice, said individualized evaluation of patients' needs was essential before, during, and immediately following treatment, and once again during the course of rehabilitation. They ultimately concluded that healthcare professionals should provide sufficient information about the next stages of care without overwhelming their patients. Furthermore, nurses should establish early on in the treatment plan how each patient wants information to be delivered to them and ... Read more

New Treatment Alternative for First Line of Attack in …

According to a recent study conducted by Manchester researchers, has proven to reveal promising results for a new treatment option in follicular lymphoma. Follicular lymphoma is a kind of non-Hodgkin's lymphoma, a blood cancer, that typically develops slowly. The majority of patients are diagnosed when the disease is at an advanced stage. Recent advancements in treatment have included the use of antibodies to purposely target the tumorcells and to stimulate the patient's own immune system to attack their tumor(s). The use of such antibodies has significantly enhanced treatment response, however unfortunately most patients are still prone to relapse. Radioimmunotherapy, a procedure in which a radioactive substance is fastened to the antibody, has been proven to be successful in treating patients who have previously relapsed. As a result, today a team made up of researchers from The University of Manchester, part of the Manchester Cancer Research Centre, have investigated the use of radioimmunotherapy treatment in newly diagnosed patients. The study published in the Journal of Clinical Oncology, examined the effects of delivering the treatment in two fractions or doses, such an approach is thought to enhance the penetration of the drug within larger tumors and also helps diminsh the side effects connected to a full dose treatment. "This was the first study to look at giving two fractions of radioimmunotherapy as an initial treatment in follicular lymphoma. We wanted to assess its safety and effectiveness in a group of high-risk patients who conventionally have done less well,” said lead researcher of the study,” Professor Tim Illidge. The researchers soon discovered that that their treatment plan was indeed practical and safe, in addition to involving very few side effects. "We saw a high overall response rate, of 94.4%, and 50 of the 72 (69.4%) patients treated in the study achieved complete response, meaning their symptoms disappeared. These results are encouraging, but we need further studies in larger numbers of patients to fully compare this treatment to the standard treatment of 6-8 cycles of chemotherapy," noted ... Read more

Survival Rate Higher for HPV-positive OPSCC patients …

Based on research presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium, a retrospective analysis of oropharyngeal patients with recurrence of disease following primary therapy in the Radiation Therapy Oncology Group (RTOG) studies ... Read more

Reduced RT Dose to Bilateral IB Lymph Nodes Improves …

According to a recent study’s findings presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium, for head and neck cancer patients receiving radiation therapy, a decline in the amount of radiation treatment quantity to the submandibular (level IB) lymph nodes eventually led to better patient-reported salivary function. The study’s research also found notable cutbacks in radiation dose to the salivary organs, and good local regional control. Researchers assessed 125 patients with node-positive oropharyngeal cancer who were administered chemoradiation at Memorial Sloan-Kettering Cancer Center in New York between May 2010 and December 2011. The mean patient age was 57. Fifty-one percent of patients had base of tongue lesions; 41 percent had tonsil cancer; and 6 percent were classified as "other." The breakdown of patients' cancer stage/classification was: 74 percent T1-2 and 26 percent T3-4. All patients had cancer with lymph node involvement, including 16 percent N1; 8 percent N2A; 48 percent N2B; and 28 percent N2C. Patients were split into two groups: those with sparing, or a reduction of radiation treatment volume to the region, of bilateral level IB nodes and those who underwent treatment without sparing. A potential questionnaire regarding xerostomia (dry mouth) to evaluate late xerostomia was given to patients in both groups at each patient follow-up visit; clinical evaluation (observer-rated) xerostomia scores were also documented. The participants who underwent treatment involving sparing experienced major improvement in patient-reported xerostomia summary scores (p=0.021) and observer-rated xerostomia scores (p=0.006) over the group in which there was no sparing. The two-year local regional control rate for the spared group was 97.5 percent and 93.8 percent for the group treated, demonstrating a low rate of cancer recurrence at the original tumor site. Additionally, study results revealed reductions in the average radiation doses to the mouth and neck regions of patients in the spared group over the group with no sparing, including the ipsilateral submandibular gland (63.9 Gy vs. 70.5 Gy; ... Read more

Voice and Speech Significantly Affected Following …

According to a new study presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium, oropharyngeal cancer patients treated with chemotherapy and radiation therapy concurrently, reported a significant drawbacks in their voice and speech ... Read more

Radiation Limited to Major Salivary Glands in Head and …

According to research presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium, steering clear of the contralateral submandibular gland during radiation therapy is very much a possibility and safe with advanced stage, node positive head and neck cancers and base of tongue lesions. Researchers from the University of Colorado Cancer Center and the Memorial Sloan-Kettering Cancer Center conducted a retrospective analysis of 71 patients from the two facilities. The average patient age was 55, and approximately 50 percent of the patients were current or former smokers. Forty patients had primary tonsil cancers, and 31 patients had tumors that involved the base of the tongue. Around 80 percent of patients had N2b or greater disease (translating in extensive lymph node involvement), and 90 percent of patients had overall stage IV disease (pointing to advanced cancer). The analysis only included patients who were undergoing treatment to the bilateral neck. All of the patients had been treated with radiation methods that avoided the contralateral submandibular gland (cSMG), which points out that it was on the opposite side of the neck as the cancer. Submandibular glands are major salivary glands found under the floor of the mouth and are in charge for the majority of unstimulated salivary flow. The average dose to the cSMG was 33.04 Gy, and at an average follow-up of 27.3 months, no patients had experienced recurrences in the contralateral level Ib lymph nodes (the area of the spared submandibular gland). "Sparing the submandibular gland from radiation can decrease the side effect of dry mouth, which has a substantial impact on patients' quality of life," said lead author of the study and an MD candidate in his final year at the University of Colorado School of Medicine, Tyler Robin, PhD. "Historically, however, there has been hesitation to spare the submandibular gland from radiation because there are lymph nodes near the gland that also end up not getting treated. While this seems worrisome because head and neck cancer spreads through the lymph nodes, it is well established that the risk of cancer involvement in the lymph nodes near the submandibular gland is exceedingly low, yet the benefit of sparing the gland for a patient's quality of life is high. It is important to consider treatment side effects alongside treatment benefit, and overall, our goal is to decrease side effects associated with radiation treatment without undertreating a patient's cancer. With modern advances in radiation therapy, it is possible to eloquently treat cancers while avoiding surrounding normal tissues. Our study is a prime example of how we can safely spare normal tissue in appropriate patients in order to decrease treatment side ... Read more

Promising Results Reported in Unilateral RT for …

According to a recent study, presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium, limiting radiation therapy (RT) to lymph nodes on one side of the neck for advanced tonsil cancer led to a good local regional control and no cancer recurrence on the untreated side. Moreover, the study results signify that main tumor location, rather than the amount of lymph node involvement on the tumor side of the neck, determines the risk for disease in the opposite side of the neck.   The study centered on 46 out of 153 total patients with squamous cell carcinoma of the tonsil who underwent treatment between 1997 and 2012 at Washington University in St. Louis.   Tumor location was well accounted for in the 46 patients who underwent unilateral RT, with 40 patients (87 percent) having lateralized (located on one side of the throat) primary tumors; two patients (4 percent) had non-lateralized tumors, and in four patients (9 percent), lateralization was inconclusive retrospectively. The patients received surgical resection and postoperative intensity modulated radiation therapy (IMRT), with 30 patients also undergoing simultaneous chemotherapy. Of the subset of 46 patients treated unilaterally, 72 percent were men, and the median patient age was 59. Sixty-one percent of patients were current or former smokers. The cancer stage/classification for the study group was: TX = 2 percent (1); T1 = 44 percent (20); T2 = 41 percent (19); and T3 = 13 percent (6). The patients' stages of lymph node involvement were: N0 = 11 percent (5); N1 = 13 percent (6); and N2 = 76 percent (35). The prescribed radiation doses were 60-66 Gy to the postoperative bed and involved neck; and 52-54 Gy to the elective neck in 30-33 fractions using a simultaneous integrated boost technique. The average follow-up time period was 2.8 years (range was .4 to 8.7 years). There were no local or regional recurrences reported, meaning the cancer did not recur in the neighboring nodes or the initial location of the cancer in any of the patients. Distant metastasis, meaning the cancer spread from the original tumor location to distant organs or lymph nodes, developed in four (9 percent) of the patients. Two patients developed second primary (new) cancers. "All treatments for cancer, surgery, radiation therapy, chemotherapy, although effective, can cause temporary and/or permanent toxicity which can affect long-term quality of life. Our research indicates that for appropriately selected patients with tonsil cancer, the volume of radiation therapy necessary to control the cancer can be significantly reduced, therefore reducing the side effects and toxicity of radiation, while maintaining a high rate of tumor control,” said study author, chief of Head and Neck Services, and associate professor of Radiation Oncology at Washington University School of Medicine, Wade Thorstad, ... Read more

Point-of-care Ultrasound Offers Total Accuracy in …

Based on a recent study conducted by a team of Mount Sinai researchers, utilizing portable ultrasound as a first-line imaging exam in kids with suspected appendicitis significantly helps deduct emergency room length of stay and decreases the need for CT scans. Other than ultrasound, often referred to as point-of-care ultrasonography, has a specificity of about 94%, meaning that it misses few cases, the Mt. Sinai researchers add. Results from the study have since been published online in the peer-reviewed journal Academic Emergency Medicine. "From an institutional perspective, this is the most common surgical problem that we encounter with children in the emergency department," said the study's senior author and associate professor of emergency medicine and pediatrics at the Icahn School of Medicine at Mount Sinai, James W. Tsung, MD, MPH. "CT scans have been the best imaging test for diagnosing appendicitis, but they expose children to radiation, which cumulatively can prove harmful, as increasing numbers of studies have shown." Numerous studies have reported lifetime risks of cancer from abdominal and pelvis CT in children between 1 fatal cancer cause for every 500 to 3,000 CT scans performed, varyingon age and sex. Efforts to try to diminish the 4 million radiation-emitting CT scans obtained in children every year are presently underway, led by front-line physicians, radiologists, and radiological professional societies. "CT scanning rate was reduced by over 35%, from a 44% CT scan rate prior to the study to a 27% rate during the study," commented assistant professor of emergency medicine and pediatrics, Icahn School of Medicine at Mount Sinai, and the study's second author, Ee Tay, MD. During the course of the study, researchers used a prospective observational convenience sample of 150 children seen uninterruptedly between May 1, 2011 and October 1, 2012 in an urban pediatric emergency department. All children were under observation for suspected appendicitis. Results were determined by surgical or pathology report in those discovered to have appendicitis and three weeks later in patients who were seen as not to have appendicitis. Operator accuracy reading the ultrasounds was reviewed in a blinded fashion by trained pediatric emergency medicine sonologists. The time to perform the point-of-care ultrasound and CT scan use was also measured. The study revealed that emergency department length of stay decreased by 2 hrs and 14 minutes (46% decrease) for those needing radiology department ultrasound and nearly 6 hours (68% decrease) for those needing CT scan when point-of-care ultrasound was uncertain as a first-line imaging study. Perhaps more significant, no cases of appendicitis were missed with the point-of-care ultrasound procedurel and no unnecessary surgeries were conducted for a normal appendix. With focused ultrasound training, pediatric emergency clinicians were able to assess ultrasound exams with the similar accuracy as radiologists (about 94% accuracy). “Surgeons are becoming more comfortable using ultrasound for decision-making and that is a big change from reliance on CT scans,” said Tsung. The Mt. Sinai Division of Emergency Ultrasound is involved with an effort to educate providers at Mount Sinai Hospital to use safer ultrasound as a faster first-line study in ... Read more

Adding Bevacizumab to Initial Glibolastoma Treatment …

According to a new study, glioblastoma (GBM) which is the most common principal malignant adult brain tumor and, regardless of treatment improvements in past years, the mean survival of patients registered in clinical trials is less than 16 months with few patients living beyond five years. GBM tumors are categorized by angiogenesis, which is the formation of new blood vessels that support tumor growth stimulated by the GBM-produced vascular endothelial growth factor A (VEGF-A). Bevacizumab is a monoclonal antibody that seeks out VEGF-A production to obstruct the growth of tumor-based blood vessels. "Clinical trials evaluating the addition of bevacizumab to standard treatment for recurrent glioblastoma demonstrated clinical benefit and led to the drug's U.S. Food and Drug Administration approval for this indication.” said Radiation Therapy Oncology Group 0825 principal investigator and professor of neuro-oncology at The University of Texas MD Anderson Cancer Center in Houston, Mark Gilbert, M.D. “Additionally, compelling preclinical data suggest that anti-angiogenic targeted therapies may normalize the tumor's rapidly forming and underdeveloped blood vessels, resulting in improved oxygen and chemotherapy delivery to the tumor and potentially enhanced radiotherapy (RT) and chemotherapy treatment.” Six hundred and twenty-one adult study participants noted in the study's final analysis were registered in the multicenter trial and randomized into one of two study arms, with treating physicians blinded to treatment assignment. All participants were treated with standard-of-care (60 Gy RT and daily temozolomide chemotherapy). Bevacizumab (experimental arm) or a placebo (standard treatment arm) was delivered starting at week 4 of RT and continued every 2 weeks until 1) disease progression, or 2) severe treatment-related toxicity, or 3) completion of adjuvant therapy. At the time of disease progression, the treatment arm was unblinded allowing for follow on treatment with or without bevacizumab. The researchers reported data at an average follow-up time of 20.5 months, which showed no statistical difference in overall survival between the two study arms (average 16.1 months for the standard-treatment arm compared to 15.7 months for the bevacizumab arm). While there was a difference in progression-free survival (PFS) (7.3 months for the placebo arm compared to 10.7 months for the bevacizumab arm), the pre-established level of benefit for PFS was not achieved. "The relevant result is that the upfront use of bevacizumab is not indicated. It's important to emphasize that the question we sought to answer was whether administering bevacizumab as first-line treatment improved survival; the cross-over component allowed comparison of risk and benefit of early versus late treatment We now know by giving it late you delay the risk of toxicity, and that may be relevant,” said Gilbert. Due to the fact that bevacizumab is known to puzzle magnetic resonance imaging (MRI) examination results used to evaluate GBM tumor progression, RTOG 0825 researchers integrated a "net clinical benefit" component in the trial design to conclude if quality of life, symptom burden and neurocognitive function test results support MRI-reported stable or improved disease status. Over 80 percent of study participants conceded to take part in the net clinical benefits component, which revealed a higher decline of cognitive function for patients in the bevacizumab arm as opposed to those in the placebo arm. "While we found a difference in progression-free survival in the bevacizumab arm, there was an overall increase in symptom burden and decline in neurocognitive function and some measures of quality of life over time comparing the patients receiving bevacizumab with those on placebo," noted Gilbert. "Study participants' consent allowing the collection of tumor tissue and blood samples, as well as imaging examination, longitudinal symptom, QOL, and neurocognitive function data provides RTOG investigators a rich archive of data to support ongoing investigations of potential molecular markers to identify subgroups of patients who may benefit from early bevacizumab," said study co-principal investigator and chair of the Radiation Therapy Oncology Group Brain Tumor Committee and a professor of radiation oncology at the University of Maryland School of Medicine, Minesh Mehta, M.D. "The RTOG 0825 results provide important insight about the use of anti-angiogenic therapies with standard first-line treatment. he unprecedented collection of specimens and associated outcome data will provide significant future information as we investigate new treatment strategies for these patients within NRG Oncology. I thank our ECOG and NCCTG colleagues for their significant trial support,” said Radiation Therapy Oncology Group chairman, co-author and executive director of the Winship Cancer Center at Emory University in Atlanta, Walter J. Curran Jr., ... Read more

MRI Offers Advancements in Treatment for Chronic …

Scientists at The University of Nottingham have recently constructed detailed structural and functional 'maps' of the human kidney made using advanced scanning technology. The research, funded with £107,623 from the Dr Hadwen Trust, a non-animal biomedical research charity, aims to further expand medical understanding on how the kidneys operate, with the main goal of leading to better monitoring and treatment for chronic kidney disease. The study will be the very first of its kind to employ magnetic resonance imaging to examine the role which oxygen plays in keeping the human kidney healthy. The study, headed led by Dr Sue Francis from the University's Sir Peter Mansfield Magnetic Resonance Centre and is in collaboration with Professor Chris McIntyre from the University's School of Medicine. "Current tests for chronic kidney disease can be very invasive and patients may need to return to the hospital on a number of occasions. The aim of this project is to produce a set of non-invasive measurements that we can produce in a single, one-hour scanning session that can assess the blood flow and oxygenation of the kidney and which could eventually be rolled out in a clinical setting to benefit patients,” said Francis. The kidneys play a crucial role in the human body, sifting waste products from the blood before changing them to urine. They also help to maintain blood pressure, regulate chemical levels in the body, keep bones healthy by producing a type of vitamin D, and stimulate the production of red blood cells. However, health conditions such as diabetes and high blood pressure can have a tremendous impact on how efficiently the kidneys can operate and can lead to chronic kidney disease, causing tiredness, water retention, weight loss, and a loss of appetite. As of today, the disease is diagnosed by a blood test which measures the GFR, glomerular filtration rate, which is the quantity of blood that is filtered through the kidneys. In more serious kidney conditions, a renal biopsy may need to be performed, which involves removing a small sample of tissue from the kidney. “Current methods can only offer a fairly crude picture of what is happening in the kidneys and how that is changing over time. For example, if one kidney is doing most of the work it can be difficult to tell and taking just a small sample of tissue from one area of the kidney may not be representative of the organ as a whole,” noted Francis. The research will instead employ magnetic resonance imaging (MRI), powered by a 3 Tesla magnet, to scan the kidney and construct a detailed picture of perfusion in the kidney, the manner in which blood is transported to and flows through the organ. Additionally, it will measure the metabolic rate of oxygen, how oxygen is consumed within the kidney, which has not been done before using MR imaging. The research aims to develop novel MRI methods, and utilize these methods in healthy volunteers to document and study the kidney's response to oxygen and CO2 changes to evaluate how the kidney behaves under stress which mimics diseased kidneys. For the next phase of the study, the researchers will scan 20 patients with diabetic nephropathy (kidney disease caused by diabetes) in a proposal to prove the effectiveness of their techniques. The scanning technique could be used to track the progression of a patient's disease and to observe the effect and effectiveness of drugs being used to treat the ... Read more

Combination of MRI/Ultrasound Imaging Enhances …

A powerful combination of MRI-ultrasound imaging system can lead to fewer biopsies and overall improved treatment decisions for prostate cancer patients. The technology, called UroNav®, merges images from magnetic resonance imaging (MRI) with ultrasound to construct a detailed, three-dimensional view of the prostate. This enhanced view aids physicians in performing biopsies with much higher precision, and increases prostate cancer detection, according to Loyola University Medical Center prostate cancer surgeon Gopal Gupta, MD. Loyola is the first hospital in Illinois to employ such a system. "This is revolutionizing how we diagnose prostate cancer and make treatment decisions. When prostate cancer is suspected due to results of a PSA blood test or digital rectal exam, a physician performs a prostate biopsy. This typically involves sticking a needle into 12 different areas of the prostate. However, this traditional method can miss a tumor. Consequently, the physician either will falsely conclude the patient does not have cancer, or will perform one or more additional biopsies to find the suspected tumor,” said Gupta. In the new fusion technique, the patient receives a MRI exam prior to undergoing a biopsy. The MRI can detect lesions in the prostate that may be cancerous. During the biopsy, the MR image is merged with ultrasound imaging. The system applies GPS-type technology to guide the biopsy needle to the lesions detected by the MRI, leading to considerably fewer needle biopsies. "Compared with traditional biopsy techniques that randomly sample the prostate, the new technology helps prevent physicians from missing hard-to-find and often aggressive prostate cancers. This potentially will help provide greater certainty regarding the extent and aggressiveness of the disease. And it could enable patients to avoid multiple and unnecessary repeat prostate biopsies,” notes Gupta. “Traditional biopsies lack precision, which can lead to either too much treatment or not enough treatment. For example, if the biopsy fails to identify an aggressive tumor, the patient may be under treated. Conversely, a patient may undergo surgery or radiation for a tumor that likely would grow too slowly to endanger the patient during his expected lifetime,” Gupta added. Biopsies guided by MRI/ultrasound fusion will allow physicians and patients to opt for active observation, when suitable. Under active observation, the patient avoids having surgery or radiation and instead undergoes periodic digital rectal exams, PSA tests and ultrasounds to see whether the cancer is growing. “MRI/ultrasound fusion is the next generation of MRI evaluation in the fight against prostate cancer," said Loyola radiologist Ari Goldberg, MD, PhD. "These leading-edge imaging technologies will improve patient care by enabling physicians to detect and characterize abnormalities at the earliest possible stages. The techniques also will give physicians better insight into whether, for example, a cancer has spread, and how effective a treatment has been,” said chair of Loyola's Department of Radiology, Scott Mirowitz, ... Read more

Radiation-free Imaging Method Efficiently Diagnoses …

According to a study recently published in The Lancet Oncology, researchers from Stanford University School of Medicine in California tested a new whole-body diffusion-weighted magnetic resonance imaging (MRI) technique. The imaging method uses ferumoxytol, an iron supplement, to significantly improve the visibility of tumors. Ferumoxytol consists of tiny superparamagnetic iron oxide particles that can be detected when using MRI. Typical imaging systems, such as PET and CT scans, are used to evaluate the development of cancer in children. However, these imaging techniques can expose children to radiation that raises their risk of secondary cancers later in life. Now, this new research has outlined a novel whole-body imaging technique that could eliminate such a risk. The research team, led by Dr. Heike Daldrup-Link, recognizes that computed tomography (CT) and F-fludeoxyglucose (18F-FDG) positron emission tomography (PET)/CT scans are the prime methods employed to see what stage cancers are at and to assess the best treatment plan. However, Daldrup-Link notes previous research has shown the secondary cancer risks linked with these techniques. According to the study background, ionizing radiation, high frequency radiation that has enough energy to damage cells' DNA, in early childhood has been demonstrated to triple the risk of lifetime cancer, as opposed to adults exposed to the radiation from the age of 30. Moreover, the researchers note that growing radiation exposure from diagnostic CT scans may almost triple the risk of secondary leukemia and brain cancer later in life. Daldrup-Link illuminates the point that children are much more sensitive to radiation than adults are, and are more likely to experience secondary cancers because they will live for a longer period following exposure. The researchers wanted to see how their new whole-body MRI technique, which uses no radiation exposure, would match up in terms of diagnostic precision with the standard F-FDG PET/CT approach. The investigators utilized both the whole-body MRI and F-FDG PET/CT to scan 22 children and young adults aged between 0 and 33 years who had malignant lymphomas and sarcomas. Mean radiation exposure was verified as zero for the whole-body MRI technique, while the F-FDG PET/CT method exposed patients to 12.5 millisieverts (mSv). The investigators discovered that the diagnostic accuracy of the whole-body MRI technique was 97.2%, as opposed to 98.3% in the F-FDG PET/CT technique. The whole-body MRI also exhibited similar sensitivities and specificities to the F-FDG PET/CT, at 93.7% vs. 90.8% and 97.7% vs. 99.5%, respectively. "Present techniques used for diagnosis and treatment, albeit effective, might bear certain risks and thus do not meet our high standards on patient care. This new imaging test might solve this conundrum of the need for diagnostic cancer staging procedures and concurrent risk of secondary cancer development later in life,” the researchers commented on their findings. Yet, in a comment piece connected to the study, Thomas C. Kwee, of the University Medical Centre Utrecht in the Netherlands, notes that “although the new whole-body MRI technique has shown success in this study, further work is needed before it can become a clinical alternative to F-FDG PET/CT." Daldrup-Link acknowledges such claims and states that the research team plans to conduct and gather further research regarding the study. She noted the team has already formed a collaboration with six centers in the US, including the University of California, San Francisco, and Stanford University, in order to test the new MRI imaging method against radiotracer-based staging examinations. "We are in the process of applying for funding at the moment and if all goes well, might be able to start the multi-center trial this fall. We already received requests from two centers in Europe who want to join in as well," said ... Read more

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