Watch this session on ECR Live: Sunday, March 8, 8:30–10:00, Room E1
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Besides personalised imaging, a new paradigm is emerging in radiology that should re-shape clinical practice and benefit the patient immensely. Supported by new technologies that enable radiologists to image the body faster and better, radiologists are now trying to broaden their focus during examinations.

If there is a field where these advances make a tremendous difference, it is cardiothoracic imaging, an area where diseases are more often than not intertwined. Cardiovascular and chest radiologists will explain how the comprehensive personalised approach impacts their work and try to convince radiologists on both sides to take an interest in the other, in a New Horizons session on Sunday at the ECR.

For years, the trend was for radiologists to subspecialise as much as they could. Cardiovascular radiologists and chest radiologists would focus on their own area with little or no interest beyond that. But among these subspecialists, an increasing number are now changing their approach, as mounting evidence shows that diseases of the heart and chest are very often related, according to Dr. Christian Loewe, deputy head of the section of cardiovascular and interventional radiology at the Medical University of Vienna, Austria.

Dr. Christian Loewe is deputy head of the cardiovascular and interventional radiology section at the Medical University of Vienna, Austria.

“In the past patients were investigated by either focusing on chest or cardiac diseases. This choice was mainly driven by their first clinical examination. However, there are a lot of situations and diseases where chest problems are caused by cardiac diseases and vice versa. There’s a huge interaction between heart and chest, and that’s why it’s interesting and important to look at this relationship in more detail today,” he said.

To prove his point, Loewe, a cardiovascular radiologist, will talk about acute and chronic chest pain during the session. Some of the most severe causes of chest pain are due to cardiovascular diseases, including myocardial infarction or acute aortic diseases. However, acute chest pain can also be caused by a number of pulmonary diseases, including pulmonary embolism, pneumonia and others. Therefore, radiologists must learn the different life-threatening disorders that cause chest pain, whether they are respiratory or cardiovascular.

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Watch this session on ECR Live: Friday, March 8, 16:00–17:30, Room C

Osteoarthritis, a degenerative joint disease, affects a large number of people worldwide. But with the emergence of new MRI techniques, researchers believe they will be able to prevent its development in the near future. Experts will present the latest methods to assess cartilage tissue quality at a very early stage and discuss remaining challenges, in a dedicated New Horizons Session, today at the ECR.

Cartilage is composed of collagen and glycosaminoglycans (GAG), which are responsible for the biomechanical properties of cartilage tissue. An interesting way to image cartilage is to look at the amount of GAG, which decreases at the onset of tissue degeneration, a process which occurs due to ageing or an induced defect, for instance trauma or surgical intervention in the joints. If left untreated, a tissue defect can lead to osteoarthritis. GAGs are known to be among the earliest biomarkers of cartilage degeneration, and if a focal reduction in the amount of GAG can be identified, then therapy to avoid further damage can begin.

Sodium image in the axial plane of the patella shows the patellar cartilage. At the border from the medial to the lateral facet of the patella an area with decreased sodium signal-to-noise ratio (SNR) is visible which corresponds to a decreased content of glycosaminoglycan (GAG) although the cartilage thickness is preserved. This means an early stage of cartilage degeneration in this area with a focal loss of GAG.
(Provided by Prof. Siegfried Trattnig and the MR Centre of Excellence)

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The brain remains undoubtedly one of the most mysterious organs of the human body. Magnetic resonance imaging has helped to unveil some of its secrets, and major advances have been made in understanding how the brain functions. Recent developments with resting fMRI (rfMRI) and diffusion MRI (dMRI) indicate that scientists are beginning to see beyond the brain: they have actually started to visualise the human mind. This new information is particularly relevant for understanding complex processes such as dementia, autism and depression. It is also proving increasingly central to the diagnosis of comas and chronic disorders of consciousness.

Leading researchers will discuss where the latest advances have led them and what the future will bring in a dedicated New Horizons Session during ECR 2013. FMRI has been used for over twenty years to visualise changes in brain activity by comparing a task versus a control task, and showing and quantifying how much brain activity is involved in the process. The recent addition of rfMRI enables researchers to track networks that are randomly active. A patient lying in a scanner with no particular task to perform will usually start thinking about the trivialities of the day and go from one thought to the other (“Did I close the door before I left? What am I doing here?” etc.). Neuroresearchers can track this mind mumbling with complex mathematics and extract information from what they call the default mode network.

Fig. 1: Differences in functional connectivity from rfMRI between autistic patients and age- and gender matched controls: the major disconnection is between the cerebellum and frontal language areas.

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