Editor’s Note: Double Take
By David Yeager
Radiology Today
Vol. 25 No. 6 P. 5

When it comes to writing and editing, it’s usually a good idea to check your work. The first draft may have mistakes or omissions that a second look or, better yet, a second pair of eyes, can find. When dealing with medical images, second opinions are not uncommon. In the course of treating a patient, a second pair of eyes on an imaging exam may reveal previously unnoticed features. But when are second opinions most useful? And are there times when they’re not useful? Those questions are the basis of this month’s cover feature.

It’s easier than ever to move medical images from patients to providers and back again, which is good. This allows patients the flexibility to have their images interpreted by whomever they choose. One offshoot of this flexibility is that it has given rise to several second opinion services that will interpret a patient’s medical imaging for a fee. The central question is whether and how much additional value can be gained. In some cases, a second read may reveal a previously undiagnosed condition. In others, it may confirm the initial diagnosis. While some experts believe these services can fill a vital role, others question whether the companies’ claims are supported by sufficient data. Beth W. Orenstein takes an in-depth look at the pros and cons of second opinion services.

Coronary CT angiography is another modality that can benefit from a closer look. Keith Loria reports on advances that allow physicians to see more than ever before. In addition to spotting plaque build-up in arteries, new techniques can distinguish between types of plaque and quantify them. Other applications can visualize blood flow through the heart and arteries to provide a more complete picture of a patient’s overall cardiovascular health.

Sometimes, new techniques are needed to better visualize pathology. One such technique, neuro optical coherence tomography, is helping researchers explore the brain’s vasculature with high-resolution images. Orenstein delves into the details to find out how this technique improves navigation through the myriad small vessels of the brain and allows physicians to characterize and treat small blood clots more effectively. Turn to page 18 to learn more.

Finally, advances in imaging and theranostics are transforming prostate cancer care. Earlier detection can lead to more effective treatments and better outcomes. In addition, theranostics is showing great promise for treatment, and new imaging agents offer the possibility of ever-better visualization. Loria has an update on the latest trends.

Enjoy the issue.