sábado 22 enero, 2022
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RSNA Highlights

Continuamos en esta nota publicando las charlas y actividades más sobresalientes de la RSNA 2004

Stem Cells May Hold Promise as Multiple Sclerosis Cure
Novel Imaging Technique Shows Abnormal Brain Anatomy in Children with A D H D
Brain Imaging with MRI Could Replace Lie Detector
Imaging Technology Solves 400-Year-Old Mystery
Patients? Own Stem Cells Used to Cure Incontinence
Brain Remapping May Be Key to Recovery from Stroke
Radiologists Help Provide Worldwide Access to Ancient Art
Smokers? Lung Cancer Risk Identified in CT Screening Study
MRI Shows Liver Tumors Freezing in Real Time

A number of exciting advances in Radiology were presented at this years conference, covering a diverse range of developments in its field.

One of the highlights of the conference came with the news that Researchers have identified stem cells that may hold promise as Multiple Sclerosis Cure.

Stem Cells May Hold Promise as Multiple Sclerosis Cure

Neural stem cells injected into mice can repair brain cells damaged by a disease similar to multiple sclerosis (MS), according to researchers who used magnetic resonance imaging (MRI) to monitor the cell’s progress through the affected brain regions.

Multiple sclerosis (MS) is a chronic, autoimmune disease characterized by the destruction of myelin, the protective layers that surround nerve cells. It can affect numerous body functions, and symptoms may include visual and speech impairment, memory loss, depression, muscle weakness, loss of coordination, numbness orpain, bowel and bladder problems and sexual dysfunction. MS affects approximately 400,000 people in the United States and as many as 2.5 million worldwide, mostly women between the ages of 20 and 50, according to the National Multiple Sclerosis Society. Over 10,000 new cases are diagnosed each year.

«Stem cells have the potential to replace the function of damaged nerve cells,» said the study’s senior author, Giuseppe Scotti, M.D., professor and chairman of neuroradiology at the University and Scientific Institute San Raffaele and dean of the Medical School, University Vita-Salute San Raffaele in Milan. ?In this case, stem cells increase the number of glial cells, the cells that produce myelin. Myelin is then restored.?

By Infusing the cells with iron particles before injection, it makes them visible on the MRI.

While EAE is not the same as MS, it closely resembles the disease in many ways, including disease progression, lesions and behavior, according to Dr. Politi. «The result in damaged tissue is very much the same,» Dr. Scotti said. «Since the stem cells try to repair the damaged tissue, the model is absolutely superimposable.»

The ability to monitor the migration of the transplanted cells is vital if the treatment is going to be adapted to MS patients. «The development if this MRI-based method to track labeled cells non-invasively represents a crucial step toward the application of this therapy to humans,»Dr. Politi said.

While the results are promising, both authors caution that further studies need to be done.

Novel Imaging Technique Shows Abnormal Brain Anatomy in Children with ADHD

A new study has indicated that children with attention deficit hyperactivity disorder (ADHD) display anatomical brain abnormalities beyond chemical imbalance.

Most of the structural anomalies were found in the fiber pathways that facilitate communication between the frontal lobe and cerebellum.
«These areas are involved in the processes that regulate attention, impulsive behavior, motor activity, and inhibition- the key symptoms in ADHD children,» said lead author of both studies, Manzar Ashtari, PhD.

According to the National Institute of Mental Health (NIMH), ADHD affects 3 to 5 percent of children in the United States. Children with ADHD have difficulty controlling their behavior or focusing their attention.

Dr. Ashtari’s team found differences in the brain fiber pathways that transmit and receive information among brain areas between diagnosed ADHD sufferers and control subjects.

In the second study, the researchers found that children who had received stimulant treatment for ADHD had fewer white matter abnormalities than children who did not receive medication.

They came to the conclusion that stimulant medications may help in the normalization of the affected fiber pathways.
«The findings from this small, cross-sectional study indicate that the therapeutic effect of stimulants may involve a brain normalization process,» Dr. Kumra concluded.

Brain Imaging with MRI Could Replace Lie Detector

According to a new study, when people lie, they use different parts of their brains than when they tell the truth, brain changes can be measured by a new process called functional magnetic resonance imaging (fMRI).

The results suggest that fMRI may one day prove amore accurate lie detector than the polygraph.

«There may be unique areas in the brain involved in deception that can be measured with fMRI,» said lead author Scott H. Faro, M.D. «We were able to create consistent and robust brain activation related to a real-life deception process.» Dr. Faro is professor and vice-chairman of radiology and director of the Functional Brain Imaging Center and Clinical MRI at Temple University School of Medicine in Philadelphia.

The researchers examined the individuals with fMRI, while simultaneously administering a polygraph exam. The polygraph measured three physiologic responses:respiration, blood pressure and galvanic skin conductance, or the skin’s ability to conduct electricity, which increases when an individual perspires. Dr. Faro’s study is the first to use polygraph correlation and a modified version of positive control questioning techniques in conjunction with fMRi.

fMRI showed activation in several areas of the brain during the deception process. These areas were located in the frontal (medial inferior and pre-central), temporal (hippocampus and middle temporal), and limbic (anterior and posterior cingulate) lobes. During a truthful response, the fMRI showed activation in the frontal lobe (inferior and medial), temporal lobe (inferior) and cingulate gyrus.

Because physiologic responses can vary among individuals and, in some cases, can be regulated, the polygraph is not considered a wholly reliable means of lie detection. According to Dr. Faro, it is too early to tell if fMRI can be «fooled» in the same manner. However, these results are promising in that they suggest a consistency in brain patterns that might be beyond conscious control.

Imaging Technology Solves 400-Year-Old Mystery

Using multi-detector computed tomography (MDCT), an advanced form of computed tomography, scientists confirmed that scurvy killed the settlers on St. Croix Island near Maine in 1604. «MDCT images are extremely important to anthropologists because we can obtain bone measurements without destroying the artifact,» said the study’s lead author, John Benson, M.D. «Using M D C T, we were able to visualize the entire skull from every angle, inside and out. Scans of the skull and leg bones revealed a thick hard palate in the mouth and an extra layer of bony tissue on the femur and tibia, which we believe resulted from the internal bleeding associated with scurvy.»

The settlement was established in 1604 by French settlers, but the island proved to be a poor choice. Isolation and harsh winter conditions claimed the lives of nearly half of the 79 colonists.

The MDCT images, which helped physicians determine the ages of the deceased also based on cut marks found in one of the skulls, researchers also believe the surviving colonists on Saint Croix Island initiated the first autopsy in the United States to better understand the disorder that was killing their compatriots.

Patients? Own Stem Cells Used to Cure Incontinence

Austrian researchers are successfully treating incontinent women with the patient?s own muscle-derived stem cells.

The technique is especially is especially promising because it is generated from the patient’s own body. The stem cells are removed from a patient’s arm, cultured in a lab for six weeks, and then injected into the wall of the urethra and into the sphincter muscle. The result is increased muscle mass and contractility of the sphincter and a thicker urethra.

Stress incontinence affects nearly 15 million people worldwide, causing urine leakage when an individual exercises, coughs, sneezes, laughs or lifts heavy objects.

Muscle-derived stem cells were removed from each patient’s arm and cultured, or grown, using a patented technique that yielded 50 million new muscle cells (myoblasts) and 50 million connective tissue cells (fibroblasts) after six weeks. When implanted into the patient under general or local anesthetia, the new stem cells beganto replicate the existing cells nearby. One year after the procedure, 18 of the study’s 20 patients remain continent.

Brain Remapping May Be Key to Recovery from Stroke

People suffering from paralysis due to stroke or traumatic brain injury may be able to reprogram their brains to improve motor skills and to control artificial limbs. Using functional magnetic resonance imaging (fMRI) and a «cyberglove» to record brain changes during motor activities, researchers demonstrated that people can learn to remap, or redirect, motor commands.

When neurons-the primary cells of the nervous system that make all thought, feeling and movement possible-are damaged by a stroke or brain injury, other neurons take over for them. But until now, scientists weren?t sure which neurons compensated for damaged neurons, or how the brain cells learned their new jobs.

Using fMRI and a special fiber-optic glove, researchers recorded which parts of the brain controlled individual hand movements. fMRI uses radio waves and a strong magnetic field to image the body. It can identify signs that neurons in a specific area of the brain are «firing,» that is, processing information and giving commands to
the body.

In addition to offering insight into the rehabilitation of stroke and brain injury patients, the study provides valuable information for the development of training strategies for brain-machine interfaces, which enable patients with brain injuries to operate external devices, such as artificial limbs, using only their brain signals. This new technology requires implanting electrodes in the brain to pick up movement-producing signals from neurons. A computer then translates those brain signals into commands instructing a robotic device to move.

Radiologists Help Provide Worldwide Access to Ancient Art

For the first time, radiologists have used computed tomography (CT) together with 3-D modeling to analyze, conserve and display an antiquity with an outer and inner surface. Using CT, researchers identified areas needing repair on a 5,300-year-old Egyptian mummy mask.

The 3-D model created from CT images allows viewing of the mask from any angle? including an inside view.

Smokers? Lung Cancer Risk Identified in CT Screening Study

For the first time, researchers can predict the lung cancer risk for social smokers as well as habitual smokers.

Data presented today at the annual meeting of the Radiological Society of North America showed that a social smoker age 50 or older has a risk for developing lung cancer similar to that of a smoker under age 50 who smoked three packs a day for 20 years.

This lead them to conclude that Age has as much impact on the likelihood of former and current smokers developing lung cancer as the number of cigarettes consumed.

Claudia I. Henschke, Ph.D., M.D., is the principal investigator of the International Early Lung Cancer Action Project (I-ELCAP), the largest study ever undertaken on whether annual screening by computed tomography (CT) can prevent deaths from lung cancer.

«Annual CT screening identifies a high percentage of Stage I diagnoses of lung cancer, the most curable form of lung cancer,» Dr. Henschke said. «Our study found that deaths from Stage I lung cancer were surprisingly low after surgery, but only if treatment is pursued.»

Smokers should consult their doctors to determine at what age CT screening should begin, but this data provides the basis for such recommendations. With annual screening, there is a 76-78 percent chance of a smoker?s lung cancer being cured, Dr. Henschke said. Without screening, the probability for cure falls to 5-10 percent.

I-ELCAP data also showed that, regardless of a smoker?s age or how much has been smoked, the risk for developing lung cancer does not decline appreciably until 20 years after kicking the habit. Lung cancer remains the major cause of cancer death in both men and women, killing more people than breast, prostate and colon cancers combined, according to the American Cancer Society.

MRI Shows Liver Tumors Freezing in Real Time

Cryotherapy combined with magnetic resonance imaging (MRI) is giving doctors unprecedented control during liver cancer treatment by allowing them to observe the tumors freezing in real time.
«We can actually watch the iceball grow,» said Kemal Tuncali, M.D. «We have better control over the means of killing the tumor with MR guidance and cryotherapy. We can also watch out for critical structures around the area that we don?t want to damage, like the bowel, stomach or gall bladder.»

Liver cancer is notoriously difficult to treat with standard methods such as chemotherapy and open surgery.
Physicians are turning to alternative ways of destroying tumors, including cryotherapy. Interventional radiologists perform cryotherapy by inserting a needle called a cryoprobe directly into the cancerous tissue and using argon gas to freeze the tumor. Using MRI, the radiologist can target the best site for placing the probe and monitor treatment as it happens to avoid damaging surrounding tissue.

Among 39 tumors treated with cryotherapy, 19 were successfully destroyed (17 with only one treatment).

A summary of the second half of the scientific presentations can be found in next months edition.

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