扩散峰度成像预估宫颈鳞癌病理分级的价值

目的：探讨扩散峰度成像(DKI)定量参数预估宫颈鳞状细胞癌(CSCC)病理分级的价值。方法回顾性分析45例CSCC患者的DKI图像,按照病理结果分为低分化组22例,高中分化组23例。由2位观察者分别测量2组病灶实质区DKI各参数值,包括平均扩散峰度值(MK)、平行扩散峰度值(Ka)、垂直扩散峰度值(Kr)、峰度各向异性分数(FAk)、平均扩散系数值(MD)、平行扩散系数值(Da)、垂直扩散系数值(Dr)及各向异性分数(FA)。采用组内相关系数(ICC)对2位观察者各参数测量结果一致性进行检验;采用两独立样本t检验比较2组各参数值;采用受试者工作特征曲线(ROC)评估各参数预估低分化 CSCC的效能,并找出相应界值。结果2位观察者测得2组病灶各参数值的一致性良好(ICC>0.75)。低分化组MK、Ka及Kr值大于高中分化组(P<0.05),低分化组 MD、Da及Dr值小于高中分化组(P<0.05),2组 FAk及 FA值间无差异(P>0.05)。MK、Ka、Kr、MD、Da、Dr值预估低分化CSCC的曲线下面积(AUC)分别为0.914、0.831、0.865、0.850、0.778、0.865,MK≥0.973、Ka≥1.075、Kr≥0.823、MD≤0.974μm2/ms、Da≤1.185μm2/ms、Dr≤0.762μm2/ms为预估低分化CSCC的界值。结论 DKI能够有效地预估CSCC的病理分级,有着很好的临床应用前景。     

DKI对震颤型帕金森患者脑深部核团微结构变化的诊断价值

【摘要】目的：探讨扩散峰度成像（DKI）对震颤型（TD）帕金森病（PD）患者脑微观结构变化的诊断价值。方法：对40例TD型PD患者及34例健康志愿者（对照组）行常规序列及DKI序列MRI检查,对PD患者的运动和认知功能障碍进行评估。MRI原始扫描数据经后处理获得DKI各定量参数图,包括各向异性分数（FA）、平均扩散率（MD）、平均扩散峰度（MK）、横向峰度（Ka）、径向峰度（Kr）、横向扩散率（Da）和径向扩散率（Dr）,分别测量双侧红核、黑质致密带、黑质网状带、壳核、尾状核头、苍白球和丘脑的各项参数值,对各项参数值在两组间及患者左、右侧对称区域间的差异进行统计学分析。结果：①FA值：患者组症状侧及对侧红核的FA值与对照组的症状对侧比较,差异有统计学意义（P=0.013、0.036）;双侧尾状核头的FA值分别与对照组双侧对应部位比较,差异均有统计学意义（P=0.002、0.012、0.006和0.033）。②MD、Da、Dr、Ka值：双侧红核、壳核、黑质致密带、黑质网状带、苍白球、丘脑和尾状核头的各参数值分别与对照组双侧对应部位比较,差异均有统计学意义（P=0.000~0.030）。③MK值：患者组症状侧的黑质网状带、黑质致密带的MK值与对照组症状对侧之间的差异有统计学意义（P=0.043、0.042）;患者组双侧壳核的MK值分别与对照组双侧对应部位两两比较,差异均有统计学意义（P=0.046、0.006、0.008和0.001）;PD组中症状侧苍白球的MK值分别与对照组双侧对应部位比较,差异均有统计学意义（P=0.008、0.005））。④Kr值：患者组症状侧尾状核头的Kr值与对照组双侧对应部位比较,差异均有统计学意义（P=0.031、0.006）。结论：DKI在TD型PD患者亚临床期即可敏感的量化分析双侧各灰质核团微观结构的改变。     

磁共振扩散峰度成像在第四脑室肿瘤鉴别诊断中的应用价值

目的应用扩散峰度磁共振(MR)成像技术探定第四脑室肿瘤内部成分及细胞增殖状态,分析其各成像参数与Ki-67的相关性,同时分析扩散峰度成像各参数在鉴别四脑室区髓母细胞瘤、室管膜瘤中的应用价值。方法收集21例四脑室区肿瘤患者,术前行常规磁共振成像(MRI)及扩散峰度成像(DKI)序列扫描。术后对标本进行S-P染色法检测Ki-67的表达,应用扩散峰度评估软件(DKE)测定肿瘤实质区平均扩散峰度(MK)、径向峰度(Kr)、轴向峰度(Ka)及平均扩散系数(MD)值、各向异性系数(FA)值。Spearman相关分析研究DKI各参数值与Ki-67的相关性,应用独立样本t检验,比较髓母细胞瘤和室管膜瘤DKI参数值的差异性,并通过ROC曲线分析MK值、FA值和MD值在鉴别诊断中的敏感性及特异性。结果不同类型四脑室区肿瘤中髓母细胞瘤平均Ki-67值最高,MK值与Ki-67存在明显正相关性,具有统计学意义(P0.01)。MK、Kr、Ka及MD值在鉴别髓母细胞瘤和室管膜瘤中均具有显著的统计学意义(P0.01),FA值则无统计学意义(P0.05)。在鉴别室管膜瘤和髓母细胞瘤时MK值的敏感性和特异性分别为88.89%和87.50%,ROC曲线下面积(AUC)为0.9722;MD值敏感性为77.78%,特异性87.50%,AUC为0.9028;FA值的敏感性及特异性最小,分别为66.67%和62.50%,AUC为0.6111。结论通过扩散峰值成像(DKI)可以更好的探定第四脑室肿瘤增殖状态,尤其MK值较其他参数值可以更好的反映肿瘤Ki-67的表达水平,且在鉴别诊断不同类型四脑室区肿瘤中具有重要意义。     

基于DKI技术对系统性红斑狼疮患者脑白质微结构改变的研究

目的 应用扩散峰度成像(DKI)技术中基于纤维束的空间统计分析方法(TBSS)探讨系统性红斑狼疮(SLE)患者脑白质结构的改变及其与神经精神量表的相关性。方法 选取41例女性SLE患者(SLE组)及45名与其年龄、性别及教育程度相匹配健康志愿者(HC组)进行DKI检查，测定有统计学差异脑区的各向异性分数(FA)、平均扩散系数(MD)、平均扩散峰度(MK)间的差异，并采用Spearman相关性分析来探讨差异脑区FA、MD及MK值与神经精神量表间的关系。结果 与HC组相比，SLE组患者在胼胝体(膝部、体部、压部)、双侧前、上放射冠、丘脑后辐射、外囊、上纵束及右侧后放射冠FA值均明显降低(P均<0.05);在胼胝体(膝部、体部、压部)、内囊膝支、双侧前、上、后放射冠、丘脑后辐射、上纵束及左侧外囊MD值均明显升高(P均<0.05),在胼胝体(膝部、体部、压部)、内囊后肢、双侧前、上放射冠、双侧丘脑后辐射、外囊、上纵束及右侧后放射冠MK值均明显降低(P均<0.05)。相关性分析发现，简易精神状态量表(MMSE)评分与胼胝体体部的FA、MK值呈正相关(r=0.5487,P<...     

新生猪缺氧缺血性脑病扩散峰度成像的时间进程变化

目的分析新生猪缺氧缺血性脑病扩散峰度成像(DKI)相关参数随时间变化规律,并与扩散张量成像(DTI)相关参数对比。材料与方法选取出生3~5 d内的健康约克种猪20只,分为实验组15只和对照组5只。实验组结扎双侧颈总动脉后放入氧浓度为4%的乏氧箱内,乏氧30 min。对照组仅行分离双侧颈总动脉的假手术。实验组和对照组在模型建立后3、6、9、12、16、24 h分别进行DKI扫描,扫描完成后,实验组和对照组各选3只猪取脑行病理学检查。结果实验组猪缺氧缺血发生后,病变处DKI相关参数平均扩散峰度(MK)、径向扩散峰度(Kr)、轴向扩散峰度(Ka)较对照组逐渐升高,差异有统计学意义(P<0.05);DTI相关参数平均扩散系数(MD)、垂直扩散张量(Dr)、轴向扩散张量(Da)逐渐降低,差异有统计学意义(P<0.05)。DKI相关参数值变化率大于DTI相关参数值变化率,且平行于轴突方向的变化率均大于垂直于轴突方向的变化率(Ka、Da、Kr及Dr的平均变化率分别为119.75%、55.54%、93.32%、50.51%)。实验组病理结果显示神经元水肿,大量炎症细胞浸润,局部可见坏死。结论与DTI相关参数相比,DKI能够更敏感地评价缺氧缺血性脑病脑组织微结构的变化。     

磁共振扩散峰度成像评价急性胰腺炎及其严重程度分级的价值

【摘要】目的：探讨磁共振扩散峰度成像（DKI）在急性胰腺炎（acute pancreatitis,AP）的诊断及严重程度分级中的应用价值。方法：按诊断标准、纳入标准及排除标准前瞻性收集57例AP患者为研究组（AP组），同期收集健康志愿者24例作为对照组（NP组），两组均行上腹部常规MRI和多b值DKI检查（b值取0、1000、2000s/mm2）。根据改良MR严重指数（MRSI）评分标准将AP组分为轻症、中重症及重症三个亚组。测量所有对象的DKI参数平均峰度（MK）、轴向峰度（Ka）、径向峰度（Kr）及其衍生参数各向异性分数（FA）、平均扩散（MD）、轴向扩散（Da）、径向扩散（Dr），比较各参数在AP组与NP组间，轻症、中重症及重症AP组间的差异。绘制各参数的ROC曲线，评价各参数评估AP严重程度分级的诊断效能。结果：57例AP中，轻症24例，中重症27例，重症6例。AP组与NP组间，MK、Ka、MD、Da、Dr均存在统计学差异（P=0.033、0.000、0.000、0.000、0.000），而FA、Kr均无统计学差异（Z=1.798，P=0.072；Z=0.186，P=0.852）。MK仅在轻症与中重症AP间存在统计学差异（Z=2.442，P=0.015），其余参数在轻症与中重症AP间，轻症与重症AP间均存在统计学差异（P均＜0.05），各参数在中重症与重症AP间均无统计学差异（P均＞0.05）。MK、Ka、Kr随严重程度加重而增加，而FA、MD、Da、Dr随严重程度加重而减小。Ka评估AP严重程度分级的诊断效能最大，其ROC曲线下面积（AUC）最大（0.743），敏感度为78.310%，特异度为75.000%。结论:DKI技术有助于AP的诊断，且对AP严重程度分级具有一定的临床价值，其中Ka的诊断效能较大。     

扩散峰度成像和3D动脉自旋标记成像对脑胶质瘤术前分级的诊断价值及相关性研究

目的：探讨扩散峰度成像（DKI）和3D动脉自旋标记成像（3D ASL）对脑胶质瘤术前分级的诊断价值及相关性。方法：收集36例经病理证实的脑胶质瘤患者,分别行常规MRI平扫、DKI、3D ASL及增强扫描,经后处理得到DKI、3D ASL相关参量图,选择肿瘤实性部分和对侧正常脑白质,分别测量平均扩散峰度（MK）、径向扩散峰度（Kr）、轴向扩散峰度（Ka）和部分各向异性（FA）、平均扩散系数（MD）、脑血流量（CBF）,并计算各相对参数值rMK、rKr、rKa、rFA、rMD和rCBF。采用两样本t检验,比较分析不同级别脑胶质瘤的各参数值及相对参数值。采用Spearman相关分析rMK值、rCBF值及病理级别三者间的相关性。绘制rMK值与rCBF值诊断高级别脑胶质瘤的ROC曲线,计算AUC,寻找最佳诊断界值,两者AUC比较行Z检验。结果 ：经检验分析,MK、Kr、Ka值在不同病理级别胶质瘤中差异均有统计学意义（均P<0.05）,FA、MD值在不同病理级别胶质瘤中差异无统计学意义（均P> 0.05）。不同病理级别胶质瘤的rMK、rKr、rKa、rFA、rMD值及rCBF值差异均有...     

扩散峰度成像对高级别胶质瘤及单发脑转移瘤的鉴别诊断价值

【摘要】目的：探讨磁共振扩散峰度成像（DKI）的多参数值对高级别胶质瘤（HGG）和单发脑转移瘤（SBM）的鉴别诊断价值。方法：搜集经手术病理或临床随访证实的19例HGG患者和14例SBM患者的病例资料,术前均行常规MRI扫描、DKI扫描及增强扫描。选取兴趣区（ROI）测定其DKI参数,并进行矫正处理得到各向异性分数（FA）、平均扩散（MD）及平均峰度（MK）值。应用独立样本t检验对两组间各参数值进行统计学分析,绘制ROC曲线计算敏感度、特异度及曲线下面积（AUC）。结果：两组肿瘤实质区DKI各参数值差异无统计学意义（P＞0.05）;而瘤周区的FA值、MD值及MK值在两组间的差异有统计学意义（P＜0.05）。ROC曲线分析显示,瘤周区的MK值鉴别两种肿瘤的敏感度和特异度较FA值和MD值高,曲线下面积最大。结论：瘤周区的FA值、MD值及MK值对HGG和SBM有良好的鉴别诊断价值,且瘤周区MK值诊断效能最高。     

扩散峰度成像对上皮性卵巢癌分型的鉴别诊断

目的 探讨扩散峰度成像（DKI）对Ⅰ型与Ⅱ型上皮性卵巢癌（EOC）的鉴别诊断价值。 方法 回顾性收集经手术病理证实的45例EOC病人的临床、病理及影像资料,平均年龄（50±13）岁。根据术后病理结果对EOC病人进行分组,分为Ⅰ型组（24例）和Ⅱ型组（21例）。所有病人均于术前行盆腔DKI检查,由2名放射科医师在DKI各参数伪彩图上分别测量平均扩散峰度（MK）、平行扩散峰度（Ka）、垂直扩散峰度（Kr）、平均扩散系数（MD）、平行扩散系数（Da）、垂直扩散系数（Dr）、各向异性分数（FA）、峰度各向异性分数（FAk）。采用Fisher确切概率检验、独立样本t检验或Mann-Whitney U检验比较2组间临床、病理及影像资料的差异,对差异有统计学意义的参数绘制受试者操作特征（ROC）曲线,分析其鉴别诊断效能。 结果 病理表现上,Ⅰ型中交界性肿瘤占比最高（50.0%）,Ⅱ型中浆液性癌占比最高（61.9%）;Ⅰ型中高分化癌占50%,Ⅱ型多表现为中低分化癌 （76.2%）,Ⅰ型EOC的分化程度高于Ⅱ型;Ⅰ型多数处于Ⅰ期（79.2%）,Ⅱ型多处于Ⅲ期(57.1%)（均P<0.05）。MRI影像上, Ⅰ型病灶多表现为囊性(41.7%)或囊实性（33.3%）,Ⅱ型多表现为实性（52.3%）;Ⅱ型（66.7%）腹水发生率高于Ⅰ型（29.2%）（均P<0.05）。Ⅰ型的MK、Ka和Kr值低于Ⅱ型,MD、Da和Dr值高于Ⅱ型（均P<0.05）。ROC曲线分析显示,MK阈值为0.504时,鉴别2组诊断的曲线下面积（AUC,0.817）最大,诊断敏感度（95.2%）、阴性预测值（92.9%）、准确度（78.9%）也最高,Da阈值为2.190时鉴别诊断的AUC（0.770）最小,而特异度（76.2%）、阳性预测值（75.9%）最高。 结论 DKI序列的定量参数MK、Ka、Kr、MD、Da及Dr均有助于鉴别Ⅰ型与Ⅱ型EOC,其中MK值鉴别诊断效能更大。     

MRI技术对术前评估肝细胞癌病理分化程度的分析

目的 探讨磁共振扩散峰度成像(diffusion kurtosis imaging, DKI)和扩散加权成像(diffusion weighted imaging, DWI)术前评估肝细胞癌(hepatocellular carcinoma, HCC)病理分化程度的诊断价值。方法 选取44例术前行MRI扫描的肝细胞癌患者，以病理结果分为低分化(n=16)、中分化(n=14)和高分化(n=14)三组。测量肿瘤实质部分的DWI成像参数：表观扩散系数(apparent diffusion coefficient, ADC)以及DKI成像参数：各向异性分数(FA)、平均扩散系数(MD)和平均扩散峰度(MK),比较不同组别各参数值的差异及相关性分析。采用ROC曲线评价DWI和DKI成像参数的诊断效能。结果 由2位医师测量各参数值的一致性较好(Alpha均>0.85)。三组间的ADC、MD和MK值差异有统计学意义(F=6.411,10.30,4.713;P=0.004,<0.001,0.014);HCC的病理分化程度与ADC、MD值呈正相关(r=0.425,P=0.004;r=0.52...     

A monitoring,feedback, and triggering system for reproducible breath-hold MR imaging

A technique is described that provides improved reproducibility of breath-holding for MR image acquisition by monitoring the superior-inferior (S/I) position of the diaphragm. The method incorporates detection of the level of inspiration using an MR signal, rapid display to the patient of diaphragm position to enable breath-hold adjustment, and triggering of image data acquisition once appropriate position is attained. The response time of the system is short, approximately 10 ms. Studies in six volunteers using this method demonstrate a considerable decrease in the S/I range of diaphragm position over 10 consecutive periods of suspended respiration. The mean range is 1.3 mm with the system, while it is 8.3 mm without using it is expected that this method will be of assistance in many abdominal and cardiothoracic studies that use breath-hold techniques.     

DSA功能性参数的提取与利用

本文介绍了在临床实际中利用功能性参数，对冠状动脉ＤＳＡ心肌血流灌注成像、冠状动脉血流量测定、左心室功能测定、肺动脉高压程度的评价等项目研究结果。重点讨论了提取ＤＳＡ功能性参数的一般方法，认为功能性参数在现代影像诊断学中的作用是对疾病做出程度、定量、动态及功能诊断。     

Fast imaging of phosphocreatine in the normal human myocardium using a three-dimensional RARE pulse sequence at 4 Tesla

PURPOSE: To investigate the use of a three-dimensional rapid acquisition with relaxation enhancement (RARE) pulse sequence for direct acquisition of phosphocreatine (PCr) images of the human myocardium. MATERIALS AND METHODS: A short elliptical birdcage radiofrequency (RF) body coil was constructed to produce a uniform flip angle throughout the chest cavity. In vivo images using a spectrally-selective RARE sequence with a spatial resolution of 1.2 cm x 1.2 cm x 2.5 cm (4 cm(3)) were acquired in nine minutes and 40 seconds. RESULTS: Scans of phantoms demonstrated excellent spectral selectivity. The signal-to-noise ratio in the myocardium ranged from 12.6 in the anterior wall to 5.3 in the mid septum. CONCLUSION: This study demonstrates that PCr data can be acquired using a three-dimensional RARE sequence with greater spatial and temporal resolution than spectroscopic techniques.     

RARE spiral T2-weighted imaging

Spiral imaging has a number of advantages for fast imaging, including an efficient use of gradient hardware. However, inhomogeneity-induced blurring is proportional to the data acquisition duration. In this paper, we combine spiral data acquisition with a RARE echo train. This allows a long data acquisition interval per excitation, while limiting the effects of inhomogeneity. Long spiral k-space trajectories are partitioned into smaller, annular ring trajectories. Each of these annular rings is acquired during echoes of a RARE echo train. The RARE refocusing RF pulses periodically refocus off-resonant spins while building a long data acquisition. We describe both T₂-weighted single excitation and interleaved RARE spiral sequences. A typical sequence acquires a complete data set in three excitations (32 cm FOV, 192 × 192 matrix). At a TR = 2000 ms, we can average two acquisitions in an easy breath-hold interval. A multifrequency reconstruction algorithm minimizes the effects of any off-resonant spins. Though this algorithm needs a field map, we demonstrate how signal averaging can provide the necessary phase data while increasing SNR. The field map creation causes no scan time penalty and essentially no loss in SNR efficiency. Multiple slice, 14-s breath-hold scans acquired on a conventional gradient system demonstrate the performance.     

Echo-Time-Encoded Burst Imaging (EBI): A Novel Technique for Spectroscopic Imaging

A new technique for rapid spectroscopic imaging is presented. The proposed experiment enables a complete mapping of the two-dimensional reciprocal space k_x, k_o, and thus the acquisition of a 1D spectroscopic image in a single scan. The properties of the pulse sequence, based on the use of a burst of low flip angle pulses, are analyzed in the framework of linear response theory, and it is shown that chemical shift information may be introduced into the spatially encoded echoes. First experimental results are presented demonstrating that 32 x 32 proton spectroscopic images may be acquired within less than 1 min with a conventional imaging system.     

Simultaneous multislice (SMS) imaging techniques

Simultaneous multislice imaging (SMS) using parallel image reconstruction has rapidly advanced to become a major imaging technique. The primary benefit is an acceleration in data acquisition that is equal to the number of simultaneously excited slices. Unlike in‐plane parallel imaging this can have only a marginal intrinsic signal‐to‐noise ratio penalty, and the full acceleration is attainable at fixed echo time, as is required for many echo planar imaging applications. Furthermore, for some implementations SMS techniques can reduce radiofrequency (RF) power deposition. In this review the current state of the art of SMS imaging is presented. In the Introduction, a historical overview is given of the history of SMS excitation in MRI. The following section on RF pulses gives both the theoretical background and practical application. The section on encoding and reconstruction shows how the collapsed multislice images can be disentangled by means of the transmitter pulse phase, gradient pulses, and most importantly using multichannel receiver coils. The relationship between classic parallel imaging techniques and SMS reconstruction methods is explored. The subsequent section describes the practical implementation, including the acquisition of reference data, and slice cross‐talk. Published applications of SMS imaging are then reviewed, and the article concludes with an outlook and perspective of SMS imaging. Magn Reson Med 75:63–81, 2016. © 2015 The Authors. Magnetic Resonance in Medicine Published by Wiley Periodicals, Inc. on behalf of International Society of Medicine in Resonance.     

Current Status of Optical Imaging for Evaluating Lymph Nodes and Lymphatic System

Optical imaging techniques use visual and near infrared rays. Despite their considerably poor penetration depth, they are widely used due to their safe and intuitive properties and potential for intraoperative usage. Optical imaging techniques have been actively investigated for clinical imaging of lymph nodes and lymphatic system. This article summarizes a variety of optical tracers and techniques used for lymph node and lymphatic imaging, and reviews their clinical applications. Emerging new optical imaging techniques and their potential are also described.     

Dynamic bioluminescence imaging for quantitative tumour burden assessment using IV or IP administration of <Emphasis Type="SmallCaps">d</Emphasis>-luciferin: effect on intensity,time kinetics and repeatability of photon emission

Introduction In vivo bioluminescence imaging (BLI) is a promising technique for non-invasive tumour imaging. d-luciferin can be administrated intraperitonealy or intravenously. This will influence its availability and, therefore, the bioluminescent signal. The aim of this study is to compare the repeatability of BLI measurement after IV versus IP administration of d-luciferin and assess the correlation between photon emission and histological cell count both in vitro and in vivo. Materials and methods Fluc-positive R1M cells were subcutaneously inoculated in nu/nu mice. Dynamic BLI was performed after IV or IP administration of d-luciferin. Maximal photon emission (PE_max) was calculated. For repeatability assessment, every acquisition was repeated after 4 h and analysed using Bland–Altman method. A second group of animals was serially imaged, alternating IV and IP administration up to 21 days. When mice were killed, PE_max after IV administration was correlated with histological cell number. Results The coefficients of repeatability were 80.2% (IV) versus 95.0% (IP). Time-to-peak is shorter, and its variance lower for IV (p < 0.0001). PE_max was 5.6 times higher for IV. A trend was observed towards lower photon emission per cell in larger tumours. Conclusion IV administration offers better repeatability and better sensitivity when compared to IP. In larger tumours, multiple factors may contribute to underestimation of tumour burden. It might, therefore, be beneficial to test novel therapeutics on small tumours to enable an accurate evaluation of tumour burden. Marleen Keyaerts is a Ph. D. fellow of the Research Foundation—Flanders (Belgium; FWO).     

Molecular imaging programs in the United States: results of a national survey

RATIONALE AND OBJECTIVES: We sought to identify and describe the characteristics of molecular imaging (MI) programs in the United States and to determine the factors considered critical for their future. MATERIALS AND METHODS: In a cross-sectional study, a validated survey was sent to members of the Society of Chairmen in Academic Radiology Departments (SCARD) in the United States, and 26 variables were studied. RESULTS: The response rate was 40.3%; 67.9% of the departments surveyed have an MI program. The main focus of 47.4% of departments is oncology. The number of radiologists working for the department was the only variable found to be significantly positively correlated with (1) number of researchers in the MI program, (2) number of MI modalities available, (3) total number of grants, and (4) having ongoing MI clinical trials. These four variables plus the number of federal grants and the space used by MI programs were independent of the geographical region, hospital size (number of beds), and department size (number of radiological examinations per year). All the MI programs received grants during 2005. Only 16.1% have no alliances with industry. Among all the departments, 82% identified staff training and recruitment as the keys for success; 78.57% considered oncology the most important future application of MI and cancer management the hospital service most affected by MI. CONCLUSION: MI programs are starting to be more widespread throughout the United States, and the trend is for more academic radiology departments to become engaged in MI activities; their development is independent of department characteristics. Radiology departments strongly agreed about the key components for success of MI initiatives and the areas that will be most affected by MI applications.