BACKGROUND AND PURPOSE:While contrast-enhanced MR imaging is the criterion standard in meningioma diagnosis and treatment response assessment, gallium 68Ga-DOTATATE PET/MR imaging has increasingly demonstrated utility in meningioma diagnosis and management. Integrating 68Ga-DOTATATE PET/MR imaging in postsurgical radiation planning reduces the planning target volume and organ-at-risk dose. However, 68Ga-DOTATATE PET/MR imaging is not widely implemented in clinical practice due to higher perceived costs. Our study analyzes the cost-effectiveness of 68Ga-DOTATATE PET/MR imaging for postresection radiation therapy planning in patients with intermediate-risk meningioma. MATERIALS AND METHODS:We developed a decision-analytical model based on both recommended guidelines on meningioma management and our institutional experience. Markov models were implemented to estimate quality-adjusted life-years (QALY). Cost-effectiveness analyses with willingness-to-pay thresholds of $50,000/QALY and $100,000/QALY were performed from a societal perspective. Sensitivity analyses were conducted to validate the results. Model input values were based on published literature. RESULTS:The cost-effectiveness results demonstrated that 68Ga-DOTATATE PET/MR imaging yields higher QALY (5.47 versus 5.05) at a higher cost ($404,260 versus $395,535) compared with MR imaging alone. The incremental cost-effectiveness ratio analysis determined that 68Ga-DOTATATE PET/MR imaging is cost-effective at a willingness to pay of $50,000/QALY and $100,000/QALY. Furthermore, sensitivity analyses showed that 68Ga-DOTATATE PET/MR imaging is cost-effective at $50,000/QALY ($100,000/QALY) for specificity and sensitivity values above 76% (58%) and 53% (44%), respectively. CONCLUSIONS:68Ga-DOTATATE PET/MR imaging as an adjunct imaging technique is cost-effective in postoperative treatment planning in patients with meningiomas. Most important, the model results show that the sensitivity and specificity cost-effective thresholds of 68Ga-DOTATATE PET/MR imaging could be attained in clinical practice.

1656 Background: Patients with cardiac sarcoidosis (CS) are often treated with prednisone to suppress myocardial inflammation. However, there is little data on outcomes in relation to myocardial inflammation suppression and/or prednisone dose. Methods: We studied 106 patients with suspected CS (54.3±1.8 years, 27% females, 46.2% biopsy confirmed) who underwent PET imaging at the University of Pennsylvania from 2008 to 2020. Patients were selected if: 1) ≥2 PET scans, 2) positive inflammation on baseline scan, 3) no immunotherapy at baseline, 4) treated with prednisone only or no treatment (NT). Prednisone initiation dose was studied at low dose (Dlow) Results: Patients were followed for 4.7 years [IQR 3.1-7.8]. In total, there were 69 MACE (5 deaths, 49 HF admissions, 43 sustained VT/VF episodes). Patients that achieved CMS/PMS at follow-up did not have worse outcomes as compared to patients who achieved no suppression, both in a crude (p=0.985) and an adjusted model for prednisone dose (p=0.940). In a model adusted for significant baseline variables, patients started on HD prednisone had significantly worse outcomes as compared to patients on the NT, LD and MD prednisone groups (p=0.003, Figure 1). Conclusion:In patients with suspected CS, myocardial inflammation suppression was not predictive of MACE, whereas, HD prednisone treatment was associated with worse outcomes. Prospective, randomized control trials are needed to validate these findings.

Purpose: Radiology departments around the world have been faced with the challenge to adapt, and recover to the COVID-19 pandemic. This study is part of a worldwide survey of radiologists' responses to COVID-19 in 18 different countries in Africa, Asia, Europe, and Latin America. The purpose of this study is to analyze the changes made in international radiology departments and practices in response to the pandemic. Methods: The 18-item survey was sent via email from April to May 2020 to radiologists in Africa, Asia, Europe, and Latin America to assess their response to COVID-19. Our survey included questions regarding imaging, workforce adjustments, testing availability, staff and patient safety, research and education, and infrastructure availability. Results: Twenty-eight survey responses were reviewed. Of the 28 respondents, 42.9% have shortages of infrastructure and 78.6% responded that COVID-19 testing was available. Regarding the use of Chest CT in COVID-19 patients, 28.6% respondents used Chest CT as screening for COVID-19. For staff safety, interventions included encouraging use of masks in patient encounters, social distancing and PPE training. To cope with their education and research mission, radiology departments are doing online lectures, reducing the number of residents in rotations, and postponing any non-urgent activities. Conclusion: In conclusion, there are disparities in infrastructure, research, and educational initiatives during COVID-19 which also provides opportunity for the global radiology community to work together on these issues. (c) 2021 Elsevier Inc. All rights reserved.

Cardiovascular conditions can exist as part of a systemic disorder (eg, sarcoidosis, amyloidosis, or vasculitis) or have systemic consequences as a result of the cardiovascular insult (eg, myocardial infarction). In other circumstances, multisystem evaluation of metabolism and blood flow might be key for evaluation of multisystemic syndromes or conditions. Long axial field-of-view PET/computed tomography systems hold the promise of transforming the investigation of such systemic disorders. This article aims at reviewing some of the potential cardiovascular applications of this novel instrumentation device.

Purpose: Approximately 20 to 35% of meningiomas are classified as World Health Organization (WHO) grade II or III, conferring increased risk of recurrence and lower overall survival. Accurate imaging is particularly important in this patient population, as postoperative scarring can confound the interpretation of conventional contrast-enhanced MRI. Somatostatin receptor 2 (SSTR2) is overexpressed in meningiomas, with very low expression in normal brain, meninges, and cranial soft tissues, allowing tumor visualization with positron emission tomography (PET) using somatostatin analogues such as Ga68-DOTATATE. DOTATATE PET has previously demonstrated superiority in the detection of postoperative recurrence as well as delineation of osseous and parenchymal invasion compared with MRI. While PET/MRI confers a higher cost of imaging compared with MRI alone, it has the potential of saving healthcare costs through decreasing radiation volumes (and thereby number of visits), as well as decreasing associated morbidity. Our purpose was to perform cost-effectiveness analysis of PET/MR in patients with intermediate-risk meningioma undergoing radiotherapy planning.

The COVID-19 pandemic had significant impact on radiology departments across the United States. Radiology departments have adjusted to the effects of the pandemic. This article presents the changes made by the Radiology department at the Montefiore Medical Center (MMC) of the Albert Einstein College of Medicine located in the Bronx, New York City which is one of the major hot spots of the COVID-19 pandemic.

•Catastrophic thrombotic storm is a rare systemic clinical entity characterized by formation of multiple thrombi.

Here we report on a renewed activity of the repeating fast radio burst FRB121102. During an on-going programme involving the INTEGRAL satellite in hard X-rays, the Arecibo, Effelsberg, and the Nan & ccedil;ay radio telescopes, several radio bursts were detected in the last days.