The Journal of Radiology Case Reports” is a new generation of interactive journals, which is dedicatedto Radiology case reports. Multiple nationally and internationally well renowned experts in the field of Radiology (RSNA, ARRS, ACR, ECR etc.) represent the editorial board to guarantee the highest quality of publications.

The peer review and editorial process conforms to international standards of peer reviewed, scientific journals. However there are significant differences:

- Interactivity is unique and allows to view the cases as seen on workstations - with scroll functions and the ability to “window and level”. An example can be seen in the following case report of the July issue.

Traditionally, case reports provide only selected images, which demonstrate the pathology or pertinent findings. This has not only a limited educational and practical value, because the user only receives selected information and cannot “find out” the answer on his own. But, what is more important is that this kind of provided information does not resemble the “real life” at the radiologist’s (or other physician’s) workstation. After a diagnostic exam has been opened, the pathology does present immediately on the first image to the examiner. The entire stack of images needs to be scrolled through and the examiner has to find the pathology himself. Furthermore, scrolling through the stack of images helps to obtain an overview of the entire environment, including the anatomical relationship. To this time, no journal was able to provide such interactive features. The Journal of Radiology Case Reports, however, offers as the first journal of its kind such an opportunity. In addition, it also offers to review the articles in several other modes, including reading the manuscript in the traditional, static way, e.g. for pint purposes.

- This journal is dedicated to Radiology case reports. Case reports are usually “neglected” by large or traditional journals, mainly due to competition with “higher value” articles (review, original research etc.) for valuable space in the hardcopy version of the journal. As a consequence, it becomes increasingly difficult to publish interesting findings in a peer-reviewed scientific environment. However, the importance of case reports is widely underestimated, since many studies, reviews and evidence based medicine are based on single or collected case reports in the literature. This was one reason, why this online journal was born: to give the opportunity to publish Radiology case reports.

- The review process is blinded and exceptional by taking usually no more than 7 days - compared to months (and even years with revisions) in traditional journals, which can be very frustrating for authors.

- As in traditional journals, the published cases are fully citable. Each article receives a DOI (Digital Object Identifier) number - In these days every up-to-date journal assigns its articles a DOI number for easier referencing.

- Medline/PubMed indexing of the journal is in process.

- The articles are available in multiple formats (Abstract, HTML, PDF, Interactive)

- The editorial team consists of nationally and internationally well renowned experts in the field of Radiology.

Journal of Radiology Case Reports

The words radiation and radioactivity cause unwarranted fear, argues Zbigniew Jaworowski of the Central Laboratory for Radiological Protection in Warsaw, Poland. Writing in the current issue of the International Journal of Low Radiation from Inderscience publishers, he suggests that because life evolved alongside ionising radiation, we can cope far better with low doses of radioactivity than is often thought. He says that changing our perspective on radiation could reduce the costs to society of the precautionary principle adopted in the aftermath of the Chernobyl incident.

Life has had billions of years to evolve defences against free radicals, reactive oxygen compounds and other physical and chemical assaults that can damage cell components, including our genetic material, DNA, explains Jaworowski. These same, powerful defence mechanisms protect us from low levels of ionising radiation - from the cosmic rays that strike the earth surface to the radioactive particles continually released from the earth’s crust into the air around us.

“As such, low levels of ionising radiation is one of the smallest risks in the environment, and causes a tiny amount of the spontaneous damage to DNA in our bodies,” he adds.

When life began on Earth almost 4 billion years ago, background radiation levels were five times higher than those we experience today. Life adjusted well, as it did to all other forms of energy to which it was exposed - heat, light, electromagnetic. This adjustment took two forms. The first suggests that exposure to low doses of radiation actually stimulates repair mechanisms that protect organisms from disease and may actually be essential for life. The second involves the development of the biochemical systems that protect organisms against the noxious effects of ionising radiation.

One thing life did not apparently do was to evolve an organ that can detect radiation. This lack of a radiation sense points to the fact that living organisms have no need to detect such a low risk phenomenon. Indeed, ionising radiation only seems exotic and mysterious to some people because it was not discovered until relatively recently, unlike light and heat say. It is nevertheless nothing more than another form of energy. The perceived distinction has serious negative consequences but has no scientific basis says Jaworowski.

Given this new perspective, Jaworowski says that the Linear No Threshold (LNT) model of radiation effects is inappropriate to current needs. However, for statistical reasons the LNT cannot be falsified and so the precautionary principle is often adopted at, what he says is, an unacceptable societal cost. LNT is based on outdated genetic experiments, which are not supported by findings from Hiroshima and Nagasaki, says Jaworowski, where no adverse genetic effects have been found in the children of those survivors exposed to high levels of radiation.

The so-called “precautionary principle”, which seeks to reduce exposure to ever lower levels and at any cost, has not proved to be “cautionary” at all. “It has led to unacceptable societal penalties, as clearly demonstrated in the aftermath of the Chernobyl catastrophe,” he explains, “The time has come to change the LNT paradigm and to base radiological safety and protection on modern knowledge and the realities of the natural radiation environment.”

Inderscience
http://www.inderscience.com

IBA (Ion Beam Applications S.A.: Reuters IBAB.BR and Bloomberg IBAB.BB) the leading global provider of PET radiopharmaceuticals, and NST (NeuroSurvival Technologies Ltd.) the leading developer of agents targeting apoptosis (programmed cell death) for molecular imaging and therapy, announced the signing of a collaboration agreement for radiolabeling and distributing APOSENSE® [18F]-ML-10, NST’s novel agent for molecular imaging of apoptosis, to sites participating in multi-center clinical trials of APOSENSE® [18F]-ML-10.

[18F]-ML-10 is a member of the APOSENSE family of molecules, a novel class of rationally-designed, small molecular probes that selectively target and accumulate within cells undergoing apoptosis from its early stages. Apoptosis is a genetically-controlled process of cell death, associated with most medical disorders, in multiple clinical areas including oncology, neurology and cardiology. APOSENSE [18F]-ML-10 is labeled with the radioisotope [18F], the most commonly used isotope for molecular imaging with positron emission tomography (PET).

IBA Molecular (a business unit of IBA) is the leading global provider of PET radio-pharmaceuticals, utilizing a global network of radio-pharmacies for labeling and distribution of [18F] labeled agents, including worldwide more than 37 cyclotron-equipped manufacturing sites.

“This collaboration is an important step in building the infrastructure necessary to enable the use of APOSENSE® in our upcoming clinical trials, and ultimately, commercialization in the U.S.,” said Yoram Ashery, CEO of NST. “We are excited to partner with IBA, a world leader in the production of radio-isotopes for imaging and therapeutics, and about our shared vision of the potential role that APOSENSE can play in helping to improve patient care in multiple disease areas.”

“This agreement is an important milestone in the expansion of our leading position in the field of radiopharmaceutical products. After the announcement in May with Wilex AG, this is the second agreement for a novel agent in the field of PET radiopharmaceuticals and it confirms our strategy of offering technology, materials and services to medical imaging centers from a single source. We very much look forward to our enhanced cooperation,” said Pierre Mottet, Chief Executive Officer of IBA.

Under the terms of the agreement, IBA and NST will initially collaborate on developing and optimizing the radio-chemistry and processes necessary for GMP-grade radiolabeling of APOSENSE compatible with commercial scale distribution. The companies further agreed to work together to supply the radio-labeled agent to multi-center clinical trial sites in the United States and to negotiate terms for commercial supply following FDA approval. Financial details were not disclosed.

APOSENSE has been studied in two European clinical trials including a phase I study in healthy volunteers to determine safety, dosimetry and biodistribution, and preliminary efficacy in patients with cerebral ischemic stroke. It is currently being evaluated in a phase IIa study in Israel for early detection of response of metastatic brain tumor to radiotherapy. NST was recently granted a “safe to proceed” letter by the U.S. Food & Drug Administration for its APOSENSE investigational new drug (IND) application. NST is preparing to expand its clinical programs into the U.S., focusing on detecting and monitoring neurovascular disorders and response to anti-cancer therapy.

About IBA

IBA delivers solutions of exceptional precision in the fields of cancer diagnosis and therapy. The company also provides sterilization and ionization solutions to improve the hygiene and safety of everyday life. IBA is listed on the pan-European stock exchange EURONEXT and belongs to the BelMid index. IBA’s leading role in the field of Molecular Imaging continues to grow through the constant innovation its technology is built upon, as well as through its worldwide radiopharmaceuticals distribution network. With an ever-increasing number of sites in North America, Europe and Asia, IBA continues to make radiopharmaceuticals, today mostly FDG, more accessible to hospitals and imaging centers across the world. Website: http://www.iba-worldwide.com.

About APOSENSE Technology

APOSENSE is a proprietary, novel class of rationally-designed, small molecules that selectively identify and accumulate within apoptotic (dying) cells in vivo. Apoptosis (programmed cell death) plays a role in many diseases across numerous clinical areas, including oncology, neurology and cardiology. Molecular imaging with APOSENSE enables real-time visualization of the biological activity of disease, its onset, change in course and response to therapy, and to personalize treatment for the individual patient. Therapeutic applications of APOSENSE technology in pre-clinical development include anticancer therapy which uses apoptotic cells in tumors as targets for specific delivery of cytotoxic compounds into the tumor. APOSENSE technology was developed by NST NeuroSurvival Technologies, a clinical stage molecular imaging and drug development company, focused on introducing novel imaging and therapeutic agents based on targeting of cells undergoing apoptosis. For more information, visit http://www.nst.co.il.

About Apoptosis

Apoptosis is a genetically-controlled program of cell death, inherent in any nucleated cell in the body and therefore often referred to also as “cell suicide”. Upon activation, the apoptotic program executes a well-characterized sequence of events by which the cell undergoes fragmentation and elimination by macrophages, without damaging the surrounding tissue. Apoptosis is a universal process of cell death and it plays a role in most medical disorders, making it one of the important processes of cell biology. For example, apoptosis has important roles in oncology, both in the process of tumor growth, as well as in treatment with most therapies which aim to induce death in cancer cells. Targeting cells undergoing apoptosis, for imaging or delivering therapy, can therefore have broad clinical applications.

About Molecular Imaging

Molecular imaging is an emerging field which aims to visualize non-invasively biological processes in-vivo. The ability to image disease-related biological processes may allow to detect disease early, characterize it better and to personalize treatment by real-time monitoring of its therapeutic effect. Molecular imaging depends on special molecules (probes) that can selectively target these biological processes, while carrying an imaging moiety for visualization, such as [18F] or other positron emitting radio-isotopes that can be visualized by positron emission tomography (PET).

APOSENSE Technology

Pressure build-up in a small sealed sample bottle in a storage safe resulted in plutonium contamination of a storage room at about 02:30 today at the IAEA’s Safeguards Analytical Laboratory in Seibersdorf.

All indications are that there was no release of radioactivity to the environment. Further monitoring around the laboratory will be undertaken. No one was working in the laboratory at the time.

The Laboratory′s safety system detected plutonium contamination in the storage room where the safe was located and in two other rooms - subsequently confirmed by a team of IAEA radiation protection experts.

The Laboratory is equipped with multiple safety systems, including an air-filtering system to prevent the release of radioactivity to the environment.

There will be restricted access to the affected rooms until they are decontaminated.

A full investigation of the incident will be conducted. The IAEA has informed the Austrian regulatory authority.

The IAEA′s Laboratory in Seibersdorf is located within the complex of the Austrian Research Centers Seibersdorf (ARC), about 35 km southeast of Vienna. The laboratory routinely analyses small samples of nuclear material (uranium or plutonium) as part of the IAEA′s safeguards verification work.

Related Resources:
Safeguards Analytical Laboratory

About the IAEA

The International Atomic Energy Agency (IAEA) serves as the world’s foremost intergovernmental forum for scientific and technical co-operation in the peaceful use of nuclear technology. Established as an autonomous organization under the United Nations (UN) in 1957, the IAEA carries out programmes to maximize the useful contribution of nuclear technology to society while verifying its peaceful use.

International Atomic Energy Agency

The Honourable Tony Clement, Minister of Health, welcomed the report of an ad hoc advisory group of health specialists that has been looking at ways to minimize potential future disruptions of medical imaging services related to the isotope supply.

The group of health specialists, including experts from the field of nuclear medicine, was convened by Health Canada in December 2007 during the prolonged shutdown of the National Research Universal nuclear reactor at Chalk River. The group provided valuable information to the Minister and the Department on the health care impacts of the resulting isotope shortage. Once the reactor was restarted and the supply of medical isotopes returned to normal, the group began work on lessons learned from the situation.

“These experts are all extremely busy people who volunteered their time during the isotope shortage and have continued to work with Health Canada officials. I want to thank them for their dedication to protecting the health and safety of Canadians,” said Minister Clement. “The paper they have produced identifies a number of key issues and provides valuable insight from the perspective of the medical community on how to mitigate impacts on the health care system should future isotope shortages occur.”

“Our primary concern is patient care. It is from this perspective that we wrote our report and made our recommendations,” said Dr. Douglas Abrams, President of the Canadian Society of Nuclear Medicine and co-spokesperson for the ad hoc health experts working group. The working group recommended that the federal government and other key players minimize the potential for future shortages, mitigate patient care consequences should shortages occur, and establish a nationwide plan to co-ordinate the supply, distribution and management of medical isotopes.

“An interruption in supply of medical isotopes affects the health of Canadians. It is essential that all parties involved work expeditiously together to support efforts to develop and implement short-term mitigation measures and secure long-term supply,” added the working group’s other co-spokesperson, Dr. Jean-Luc Urbain, President of the Canadian Association of Nuclear Medicine.

Minister Clement noted that the Government has already taken action to address some of the recommendations made by the group. For example, a new communication protocol has been developed by Health Canada, Natural Resources Canada and Atomic Energy Canada Limited to ensure the rapid dissemination of information about future shutdowns of the Chalk River reactor.

The paper notes that the supply system for medical isotopes is complex, and the panel’s recommendations go beyond areas solely under federal jurisdiction to suggest actions that could be taken by the many different players involved. The report is one of many reviews currently underway related to the reactor shutdown and the isotope supply. Minister Clement said the Government will consider all these perspectives as it moves forward on this issue.

The report, entitled Lessons learned from the shutdown of the Chalk River reactor , is available on the Health Canada Web site.

Health Canada

Speaking on the publication of Lord Darzi’s Next Stage Review of the NHS, Professor Andy Adam, the President of The Royal College of Radiologists, said, “Lord Darzi has produced an outstanding set of recommendations that promise to revolutionise the way health care is delivered in this country. His report is visionary, ambitious and substantial. For the first time in the sixty-year history of the NHS the quality of care delivered to patients assumes certain stage. This is done not just in words and promises, but through methods designed to measure clinical outcomes and to reward the delivery of high standards of clinical care.”

“We are encouraged by the recognition of the central role of clinicians in achieving the aims set in the report. Clinical Radiologists and Clinical Oncologists will particularly welcome the emphasis on innovation and the adoption of new technology. We are pleased to note the extended role envisaged for the National Institute for Clinical Excellence (NICE), and the focus on the better use of evidence to encourage the rapid implementation of medical advances.

“The recommendations set out a clear and most welcome strategic direction for a rejuvenated NHS fit for the 21st century. Of course, the success of many of the envisaged changes will depend on the details of their implementation. The RCR will do all it can to enable Lord Darzi’s vision to be realised and we look forward to working with the Department of Health and the other Royal Colleges to achieve the aims laid out in the review.”

Notes

1. The Royal College of Radiologists (RCR) has approximately 7,500 members and Fellows worldwide, representing the disciplines of clinical oncology and clinical radiology. All members and Fellows of the College are registered medical or dental practitioners.

2. The Radiology Accreditation Project (RAP) has been jointly developed by The Royal College of Radiologists and The Society and College of Radiographers. The project aims to develop a process for accrediting services offering diagnostic and/or interventional radiology in the UK. For more information see the RAP website here.

Royal College of Radiologists

A breast cancer patient’s age alone should not determine whether or not she receives standard breast-conservation treatments, including a lumpectomy and radiation therapy; however, if additional health problems (comorbidities) are present, treatments should be individualized based on age and the type of comorbidities, according to a study in the April 1 edition of the International Journal for Radiation Oncology Biology Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.

The occurrence of breast cancer in women increases as women age. According to the National Cancer Institute’s SEER Cancer Statistics Review, women between the ages of 75 and 79 have the highest incidence of breast cancer diagnoses at 497 cases per 100,000 people. Along with cancer, most women in this age group are dealing with additional health problems. According to a 1999 women’s health and aging study in the Journal of Clinical Epidemiology, the majority of older patients diagnosed with cancer have at least one other medical condition and more than half of patients with cancer over the age of 65 have three or more associated medical conditions.

This study, conducted by the departments of Radiation Oncology, Biostatistics and Epidemiology, and Medicine, Division of Geriatrics, at the University of Pennsylvania School Of Medicine in Philadelphia, sought to determine the impact of these additional medical problems on breast cancer patients who receive the same standard treatments as patients with no additional medical problems and if old age is a reason to deny some standard treatments.

Most randomized trials that compare outcomes of breast-conserving surgery with and without radiation consistently show more positive outcomes when radiation is used; however, most of the trials exclude women older than 70 years old so there is not a lot of data on the impact of radiation on older women.

Between 1979 and 2002, 238 women, 70 years old and older, with Stage I or II invasive carcinoma of the breast received breast-conservation therapy and their outcomes were compared by age groups and comorbidities. Most of the patients studied had mild comorbidities.

The researchers found that the number of deaths from breast cancer among the patients studied was similar to the number seen among all age groups of patients without additional medical problems. The researchers also found that the majority of elderly women with early-stage breast cancers and mild comorbidities actually benefited from the use of radiation and had minimal side effects.

The overall survival rates for the patients in the five- and 10-year follow-up periods were 80 percent and 50 percent, respectively; however, more deaths during the 10-year period were caused by intercurrent diseases than breast cancer.

“Doctors need to understand that comorbidities should be the determining factor in deciding an older patient’s course of treatment, not age,” said Eleanor Harris, M.D., clinical director of radiation oncology at the Moffitt Cancer Center in Tampa, Fla. “There is a sense in the field that elderly women need less treatment than younger women, but we should not be under treating women simply because they have passed the age of 70.”

ASTRO is the largest radiation oncology society in the world, with 9,000 members who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, biology and physics, the Society is dedicated to improving patient care through education, clinical practice, advancement of science and advocacy.

American Society for Therapeutic Radiology and Oncology (ASTRO)
8280 Willow Oaks Corporate Dr., Ste 500
Fairfax, VA 22031
United States
http://www.astro.org

MEDX, Inc. released NuQuest(R) V3.0 , the newest version of its nuclear medicine image acquisition and processing software. The updated design vastly increases usability and enhances nuclear medicine connectivity options. The new software is a substantial upgrade from previous versions; its new features include remote desktop support, a quick select menu, completely customizable acquisition and display, and full DICOM 3.0 compatibility including modality worklist.

NuQuest® V3.0 allows users to rapidly acquire image data with just one click of the mouse. In addition, customers can process while acquiring, and create standardized documentation layouts for consistent reading and reporting. With flexible data transfer options, clients can review their nuclear medicine data from anywhere in the world on nearly any computer.

NuQuest® can now be connected to virtually every gamma camera on the market to increase speed, usability and connectivity. The data is also fully compatible with any of the four major cardiac quantification packages. Available in acquisition only, processing only, or acquisition and processing configurations, there are purchase options that fit every need and budget. All NuQuest® software operates on an intuitive Windows® operating system and provides state of the art technology for superior image quality.

MEDX has been a leading provider of high quality new, remanufactured and refurbished nuclear medicine equipment, service and parts for over thirty-five years. The company is known for their quality systems and expert service and has delivered over 3,000 nuclear imaging systems and accessories to facilities all over the world. MEDX continues to offer complete nuclear medicine coverage included accreditation assistance, multi-vendor field service, multi-vendor certified parts, 24/7/365 technical phone support, professional applications training, and 24-hour US service response.

MEDX, Inc.

The American Society for Therapeutic Radiology and Oncology has received a record number of abstract submissions for the scientific program to be held at its 50th Annual Meeting taking place September 21-25, 2008, in Boston.

A total of 2,036 abstracts were received, which is almost 400 more than the amount received in 2007, with submissions in all three of the main categories of abstracts increasing. The number of clinical abstracts rose from 1,205 to 1,301, biology abstracts increased from 156 to 178 and physics abstracts increased from 312 to 556.

The number of submissions from overseas was also up this year. ASTRO received 240 abstracts from Europe, compared to 187 in 2007, and 312 from Asia, compared to 240 last year.

“I’m thrilled that ASTRO has broken yet another record for abstract submissions and that as a result the process for selecting the top abstracts is becoming more and more competitive,” said Patricia J. Eifel, M.D., FASTRO, ASTRO president and a professor of radiation oncology at The University of Texas M.D. Anderson Cancer Center in Houston. “The number of abstracts submitted this year is a testament to how well-respected the ASTRO Annual Meeting is among medical professionals working in the field of oncology.”

The ASTRO Annual Meeting is the premier scientific meeting in radiation oncology and attracts more than 11,000 oncologists of all disciplines, physicists, biologists, nurses and other healthcare professionals from all over the world. The theme of this year’s meeting is “50 Years of Learning, Caring and Collaboration in the Treatment of Cancer Patients” and will highlight the accomplishments of ASTRO’s past, while addressing lessons learned in radiation oncology and goals for the future of the specialty.

ASTRO is the largest radiation oncology society in the world, with 9,000 members who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, biology and physics, the Society is dedicated to improving patient care through education, clinical practice, advancement of science and advocacy.

The American Society for Therapeutic Radiology and Oncology

Engineers at Purdue University are creating a wireless device designed to be injected into tumors to tell doctors the precise dose of radiation received and locate the exact position of tumors during treatment.

The information would help to more effectively kill tumors, said Babak Ziaie, an associate professor in the School of Electrical and Computer Engineering and a researcher at Purdue’s Birck Nanotechnology Center.

Ziaie is leading a team that has tested a prototype “wireless implantable passive micro-dosimeter” and said the device could be in clinical trials in 2010.

“Because organs and tumors shift inside the body during treatment, a new technology is needed to tell doctors the exact dosage of radiation received by a tumor,” Ziaie said.

The prototype is enclosed in a glass capillary small enough to inject into a tumor with a syringe, said Ziaie, who has a dual appointment in Purdue’s Weldon School of Biomedical Engineering.

Research findings are detailed in a paper appearing in the June issue of IEEE Transactions On Biomedical Engineering. The paper was written by doctoral student Chulwoo Son and Ziaie.

Whereas conventional imaging systems can provide a three-dimensional fix on a tumor’s shifting position during therapy, these methods are difficult to use during radiation therapy, are costly and sometimes require X-rays, which can damage tissue when used repeatedly, Ziaie said.

The new device uses radio frequency identification, or RFID, technology, which does not emit damaging X-rays.

The device, which has no batteries and will be activated with electrical coils placed next to the patient, contains a miniature version of dosimeters worn by workers in occupations involving radioactivity. The tiny dosimeter could provide up-to-date information about the cumulative dose a tumor is receiving over time.

“It’s a radiation dosimeter and a tracking device in the same capsule and will be hermetically sealed so that it will not have to be removed from the body,” Ziaie said.

The same researchers in 2007 reported findings on the first such miniature device. However, the earlier prototype lacked adequate sensitivity, was too large and not suitable for easy implantation, Ziaie said.

New findings detail the development of a miniaturized and more sensitive dosimeter that can be implanted using a hypodermic needle. Researchers tested the prototype with radioactive cobalt.The researchers have been funded by the National Science Foundation and recently received a two-year grant from the National Institutes of Health to continue the work. Over that time, the research team will work to simplify the fabrication process so that the devices could be manufactured inexpensively.

A key advantage of the technology is that it does not require intricate circuitry, which could make the device easier and less expensive to manufacture than more complex designs. The system consists of simple electronic devices called capacitors and coils.

The device has a diameter of about 2.5 millimeters, or thousandths of a meter, and is about 2 centimeters long, making it small enough to fit inside a large-diameter needle for injection with a syringe. The current size is small enough to be used in tumors, but researchers will work to shrink the device to about half a millimeter in diameter and half its current length, roughly the size of a rice grain, said Ziaie, who is working with Byunghoo Jung, a Purdue assistant professor of electrical and computer engineering.

The Purdue engineers also are working with researchers at the University of Texas Southwest Medical Center at Dallas.

The Birck Nanotechnology Center is part of Purdue’s Discovery Park.

http://www.purdue.edu