title: Utility of magnetic resonance contrast agents in routine cranial imaging. Case study of an evaluative method.
abstract: Scientific studies that document the utility and value of MR imaging in routine clinical practice must differ from double-blind, randomized clinical trials. The case study in this article represents an effort to create pragmatic methods for these clinical environments. An independent, judicial panel reviewed blinded readings of unenhanced and enhanced MR images. This panel determined that Gd-DTPA enhancement improved the readings that were close enough for clinical purposes--called Diagnostic Merit. More importantly, clinical care was not disrupted, and statistically significant benefits were shown in routine practice. Such studies could lead to earlier reimbursement for useful imaging technologies.
authors.affiliation: Center for Imaging and Pharmaceutical Research, Charlestown, Massachusetts.
authors.forename: G L
authors.initials: GL
authors.lastname: Wolf
authors.forename: S J
authors.initials: SJ
authors.lastname: Walsh
authors.forename: B J
authors.initials: BJ
authors.lastname: McNeil
mesh_terms: D000704:Analysis of Variance; D001921:Brain / Q000033:anatomy & histology*; D001927:Brain Diseases / Q000175:diagnosis*; D003287:Contrast Media; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D015588:Observer Variation; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D016037:Single-Blind Method
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA