Increased MRI Use May Be Driving Increase in Mastectomies

After a seven-year dip in numbers, researchers at the Mayo Clinic in Rochester, Minnesota, have witnessed a steady increase in the number of mastectomies performed there in the past three years.  Evidence reveals a correlation between the higher number of mastectomies performed during the early stages of breast cancer and the use of diagnostic magnetic resonance imaging (MRI) prior to surgery. Read more

MRI May Predict Fibrosis of the Liver

Med Headlines - According to a recent study conducted at the New York University Medical Center, chronic liver disease can be predicted with the use of diffusion-weighted MRI (DWI). “Due to the increased incidence of chronic hepatitis in the United States, particularly hepatitis C, there is a strong need for non-invasive methods to replace or supplement liver biopsy, which is relatively incidence and limited by inter-observer variability and sampling error,” reported Bachir Taouli, MD, lead author of the study. At first glance diagnosis DWI appears effective, but it needs more validation.

Researchers compared apparent diffusion coefficients (ADCs) or the quantification of water dispersion in a tissue between patients who had fibrosis stage 2 or greater versus stage 1 or less, and stage 3 or greater versus stage 2 or less fibrosis. Decreased ADC or limited water diffusion, is associated with lower perfusion and increased collagen deposition. Data suggest that hepatic ADC may be able to predict higher stages of liver fibrosis.

The study is currently in an experimental stage and needs to be tested to a greater extent. In order for the technique to be validated, It will have to be compared to other techniques, such as Fibro Test i.e., a count based on combination of basic serum makers, and FibroScan i.e., a method to measure liver stiffness based on ultrasound. Though the potential benefits have been shown by the diffusion imaging for reducing the count of biopsies and for decreasing the count of antifibrogenic drug trials, Dr. Taouli said, “We did not expect to have such good results in terms of detection of significant fibrosis, partly because this is an investigational study and we did not have any prior experience with such application.”

The Society of Gastrointestinal Radiologists has funded this preliminary investigation. Scientists are now applyting for additional funding from the National Institutes of Health.

The study has been published in the October issue of the American Journal of Roentgenology.