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  • JAMA September 5, 2017

    Figure: MRI for Neonates

  • JAMA April 18, 2017

    Figure: Relief for Dust Mite Allergy

  • New Insights on How Immune Cells Breach Blood Vessel Walls

    Abstract Full Text
    JAMA. 2017; 317(9):899-899. doi: 10.1001/jama.2017.1067
  • JAMA September 13, 2016

    Figure 1: Flow of Patients Through the Study of Noninvasive Imaging and Angiography Rates

    ACS indicates acute coronary syndrome; CABG, coronary artery bypass grafting; CHD, coronary heart disease; NICE, National Institute for Health and Care Excellence; PCI, percutaneous coronary intervention.aPatients may have received more than 1 test, in addition to or as an alternative to their strategy.
  • JAMA August 16, 2016

    Figure 2: Clinical Imaging of Aortic Dissection and Intramural Hematoma From Different Patients

    A, Type A aortic dissection, axial contrast enhanced computed tomography (CT) at the level of the pulmonary artery bifurcation (star = false lumen). B, Type B aortic dissection, axial contrast enhanced CT at the level of the carina (star = false lumen). C, Type A aortic dissection, sagittal contrast enhanced CT (arrowhead = dissection plane). D, Type B aortic dissection, sagittal contrast enhanced CT. Note the false lumen along the inner (anterior) curve of the aorta. (arrowhead = dissection plane). E, Type A intramural hematoma, coronal contrast enhanced CT (star = hematoma). F, Type B intramural hematoma, sagittal contrast enhanced CT. Arrowheads point to hematoma within the wall of the descending aorta. Note heterogeneous hyperintensity corresponding to blood.
  • Pancreatic Cyst Disease: A Review

    Abstract Full Text
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    JAMA. 2016; 315(17):1882-1893. doi: 10.1001/jama.2016.4690

    This narrative review summarizes types of pancreatic cysts and management strategies for each based on a synthesis of the published literature.

  • Protease-Activated Fluorescent Probe Shows Promise as a Cancer Imaging Device

    Abstract Full Text
    JAMA. 2016; 315(12):1217-1218. doi: 10.1001/jama.2016.0510

    This Medical News & Perspectives article discusses a clinical trial studying a new technique for imaging cancerous tissue that uses a protease-activated fluorescent probe and a handheld camera.

  • High-Value Care

    Abstract Full Text
    free access
    JAMA. 2015; 314(22):2462-2462. doi: 10.1001/jama.2015.16990
  • JAMA November 10, 2015

    Figure: Study Enrollment and Participation

    IV indicates intravenous.aEstimated glomerular filtration rate of 45 mL/min/1.73 m2.bRecognized myocardial infarction and scars were detected by electrocardiogram or by clinical evaluation. Typical scars, detected by cardiac magnetic resonance (CMR) imaging, involved subendocardium in a coronary artery distribution; atypical scars predominantly affected midwall or subepicardium, usually without subendocardial involvement and in a noncoronary artery distribution.
  • JAMA October 13, 2015

    Figure 4: Cardiac Magnetic Resonance Images From a Patient With Acute Pericarditis

    Findings characteristic of acute pericarditis that may be observed with cardiac magnetic resonance (CMR) imaging include pericardial thickening and evidence of pericardial edema. A, T1-weighted 4-chamber view showing thickened pericardium (yellow arrowhead). B, STIR T2-weighted 4-chamber view showing a pericardial hyperintense signal (yellow arrowhead) that indicates pericardial edema and left pleural effusion (black arrowhead). C, Late gadolinium enhancement 4-chamber view showing late enhancement of the pericardium (yellow arrowhead). Late gadolinium enhancement may persist beyond the acute phase of pericarditis indicating organizing pericarditis (chronic inflammatory pericarditis and fibrosis). D, Real-time free-breathing cine images, midventricular short-axis views, in expiration (left) and inspiration (right) showing septal flattening during inspiration (blue arrowhead), indicating accentuated ventricular interdependence. Images courtesy of Patrizia Pedrotti, MD, Giuseppina Quattrocchi, MD, and Alberto Roghi, MD, Ospedale Niguarda, Milan, Italy.
  • JAMA September 8, 2015

    Figure: Advanced Multimodal Imaging in a Case of a 56-Year-Old Left-Handed Woman With Medically Refractory Epilepsy

    A, Magnetoencephalography identified a few possible abnormal discharges in the left temporal lobe, shown here as fused images with high-resolution T1-weighted anatomical magnetic resonance (MR) images. B, Metabolic imaging with simultaneous 18F-fluorodeoxyglucose–positron emission tomography/magnetic resonance imaging (18FDG PET/MRI) demonstrated hypometabolism in the left posterior medial temporal lobe. Arrowheads indicate decreased glucose uptake in the left posterior medial temporal lobe. C, Gradient echo MR image obtained at 7 T demonstrated extensive blood products abutting the left hippocampal tail along with a possible large draining vein. D, MR angiography performed at 7 T showed no abnormal vasculature in the left mesial temporal lobe. E, Task-based fMRI for presurgical planning showed right hemisphere activation corresponding to language eloquent cortex. F, Functional connectivity analysis with resting-state fMRI showed decreased connectivity throughout the default mode network in the left cerebral hemisphere. Surgical resection of the lesion in the left mesial temporal lobe demonstrated a thrombosed arteriovenous malformation.
  • JAMA August 11, 2015

    Figure: Identification of Clinical Studies Examining High-Risk Therapeutic Devices Receiving Initial Marketing Approval via the FDA Premarket Approval Pathway in 2010 and 2011

    “Unknown” includes studies of both terminated and unknown status. The 26 completed postmarket studies comprised 6 completed FDA-required postapproval studies (PAS) and 20 completed manufacturer/investigator-initiated postmarket studies (ie, “non–FDA-required postmarket studies”). Similarly, the 153 ongoing postmarket studies comprised 23 ongoing FDA-required PAS and 130 ongoing manufacturer/investigator-initiated postmarket studies. FDA indicates Food and Drug Administration; SSEDs, FDA Summaries of Safety and Effectiveness Data.aAll nontherapeutic (ie, diagnostic) devices (including detection kits, molecular assays, and imaging machines) and therapeutic devices that were previously marketed in the United States for another indication.
  • Appropriateness of Advanced Diagnostic Imaging Ordering Before and After Implementation of Clinical Decision Support Systems

    Abstract Full Text
    free access
    JAMA. 2015; 313(21):2181-2182. doi: 10.1001/jama.2015.5089

    This observational study uses computerized radiology order entry and clinical decision support systems to examine the proportion and appropriateness of those orders placed by participating clinicians in 8 states between the baseline and intervention periods.

  • ED Visits for Strokes Decline While Imaging Rates Increase

    Abstract Full Text
    JAMA. 2015; 313(18):1788-1788. doi: 10.1001/jama.2015.4251
  • FDG-PET/CT Imaging for Mediastinal Staging in Patients With Potentially Resectable Non–Small Cell Lung Cancer

    Abstract Full Text
    JAMA. 2015; 313(14):1465-1466. doi: 10.1001/jama.2015.2365

    This JAMA Clinical Evidence Synopsis summarizes a Cochrane review of the accuracy of 18F-fludeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) for distinguishing potentially resectable from nonresectable non–small cell lung cancer (NSCLC).

  • JAMA April 14, 2015

    Figure: Sensitivity and Specificity by Subgroup for FDG-PET/CT Imaging for Mediastinal Staging in Patients With Non–Small Cell Lung Cancer

    Source: Data adapted with permission from Wiley. FDG-PET/CT indicates 18F-fludeoxyglucose–positron emission tomography/computed tomography. To convert becquerels (Bq) to curies (Ci), 1 Bq ≈ 2.7 × 10−11 Ci.aCriteria for test positivity refers to criteria used by studies to define a positive FDG-PET/CT result. Lymph node activity > background activity refers to FDG uptake in the lymph node more than background uptake. SUVmax refers to maximum standardized uptake value of FDG.bMixed refers to studies that used more than 1 brand of PET/CT scanner for obtaining the study data, but collapsed the data across all the brands used.
  • JAMA April 14, 2015

    Figure 1: Regions of Cerebral Hypoperfusion Following Acute Ischemic Stroke

    MRI indicates magnetic resonance imaging. A, Schematic representation of regions of hypoperfused brain tissue following acute occlusion of the middle cerebral artery. The ischemic core is an area of irreversible ischemia and cell death; ischemic penumbra, potentially salvageable tissue with prompt reperfusion; benign oligemia, decreased perfusion but no infarction risk regardless of treatment. The infarct core can enlarge into the penumbra if reperfusion is not successful. B, Top, Axial diffusion-weighted MRI (DWI) showing a hyperintensity consistent with irreversible ischemia (ischemic core) in the deep perforating territory of the right middle cerebral artery affecting the caudate, internal capsule, and lentiform nucleus. Bottom, Axial perfusion-weighted MRI (PWI) at the same level as the DWI showed a much larger area of hypoperfusion. Perfusion-weighted imaging uses contrast material to estimate cerebral blood flow. The color scale represents mean transit time of a contrast bolus; blue indicates normal transit time and shades of green, yellow, orange, and red indicate delay in transit time (ischemia). The region of the ischemic core as defined in the DWI shows areas of no contrast (black) in the PWI, indicative of irreversible injury. The area with abnormal transit time surrounding the core is considered the ischemic penumbra. These images are from a 49-year-old patient who presented with sudden onset of dysarthria and left hemiparesis. The MRI images were obtained following intravenous recombinant tissue plasminogen activator administered approximately 50 minutes after symptom onset to assess eligibility for mechanical thrombectomy.
  • Acute Stroke Intervention: A Systematic Review

    Abstract Full Text
    JAMA. 2015; 313(14):1451-1462. doi: 10.1001/jama.2015.3058

    This systematic review summarizes the pathophysiology of acute brain ischemia and infarction and available reperfusion treatments.

  • Association of Early Imaging for Back Pain With Clinical Outcomes in Older Adults

    Abstract Full Text
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    JAMA. 2015; 313(11):1143-1153. doi: 10.1001/jama.2015.1871

    This prospective cohort study found that health outcomes for elderly patients with back pain were no better for those who underwent early diagnostic imaging than those who did not.