R&E Grant Deadlines Approaching
Individuals interested in applying for 2009 grants from the RSNA Research & Education (R&E) Foundation can prepare their applications online at grants.rsna.org/grants.
Application deadlines are:- January 10, Education Grants
- January 15, Research Grants
- February 1, Medical Student Grant
For more information on grants offered by the Foundation, go to RSNA.org/Foundation or contact Scott Walter, M.S., Assistant Director, Grant Administration at 1-630-571-7816 or swalter@rsna.org.
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Research
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Latest News From RSNA 2008
Not at RSNA 2008 in Chicago? You can still stay informed about the latest news from the meeting through the RSNA 2008 Daily Bulletin at www.RSNA.org/bulletin.
Leading the News
Eight FDA Researchers Submit a Letter to Congress Raising Concerns About the Agency's Device-Approval Procedures
The House Committee on Energy and Commerce has released a letter sent to Congress by eight FDA scientists claiming that FDA officials have ignored some researchers' concerns regarding the agency's approval of medical devices they found to be unsafe or ineffective. According to the letter, the researchers initially wrote a letter to FDA Commissioner Andrew C. von Eschenbach in May stating that they were in possession of documentary evidence demonstrating that senior agency managers "corrupted the scientific review of medical devices" by instructing researchers to alter their opinions and conclusions. In response to the initial letter, Dr. von Eschenbach requested that FDA assistant commissioner for integrity and accountability William McConagha investigate the accusations. After reviewing the documentary evidence presented by the researchers, McConagha concluded that the evidence was sufficient to justify disciplinary action and recommended removal of several agency managers. However, an unnamed, high-level agency manager, after conducting his own investigation, decided against taking any action regarding the complaints and allowed the agency managers to remain in their positions, where they reportedly subjected the researchers who made the initial complaint to repeated reprisals. The letter to Congress also asks Congress to consider reforming the FDA's approval procedures for medical devices.
From "FDA Scientists Accuse Agency Officials of Misconduct"
New York Times (11/18/08) Harris, Gardiner
Research
Insight Into 'Dancing' Atoms: To Make Better MRI Images, Let the Atoms Spin Out of Control
Researchers led by Ohio State University Prof. Philip Grandinetti recently made a theoretical discovery that could significantly improve the quality of magnetic resonance imaging (MRI). Their study, reported in the Journal of Chemical Physics, found that atoms in adiabatic nuclear magnetic resonance (NMR) experiments that appear to be controlled by scientists, are actually moving on random paths dictated by the quantum mechanical concept of super-adiabaticity. However, scientists had not previously uncovered the atom's path because atoms controlled by super-adiabaticity still end up in the same location as they would be if they were actually controlled by the researchers. Based on this discovery, Grandinetti and his team were able to develop and algorithm that he hopes to incorporate into software for controlling MRI measurements to improve image resolution. Additionally, Grandinetti believes the algorithm may eventually be used to create a portable MRI by allowing it to obtain signals from objects located outside of a magnet.
From "Insight Into 'Dancing' Atoms: To Make Better MRI Images, Let the Atoms Spin Out of Control"
Science Daily (11/28/08)
Radiation Before Surgery Improves Pancreatic Cancer Outcomes
The use of neoadjuvant radiation may reduce the risk of death for pancreatic cancer patients by 45 percent compared to other treatment strategies, according to a team led by Dr. David Sherr, assistant professor of clinical radiation oncology at Weill Cornell Medical College, and a radiation oncologist at Weill Cornell Medical Center. Their research, published in the International Journal of Radiation Oncology, Biology, and Physics, analyzed data from 3,885 cases of resected pancreatic cancer recorded between 1994 and 2003. From this data, the team found that the overall survival of patients who received neoadjuvant radiation was 23 month, compared with 17 month for those receiving post-surgical radiotherapy and 12 months for patients who received surgery alone. Although Sherr acknowledges that a randomized, blinded clinical trial should be conducted to confirm these results, he is hopeful his findings may lead to an improved treatment model for pancreatic cancer.
From "Radiation Before Surgery Improves Pancreatic Cancer Outcomes"
Cornell News (11/25/08)
Some Cancers Detected by Mammography May Disappear Without Treatment
Some cancers detected by mammography may disappear without treatment, according to a new study conducted by Per-Henrik Zahl of the Norwegian Institute of Public Health and his colleagues. For their research, published in the Archives of Internal Medicine, Zahl and his team examined breast cancer rates among 119,472 women between the ages of 50 and 64 years who had three screening mammograms between 1996 and 2001. They then counted breast cancers among a control group of 109,784 unscreened women. Six years later, all of the women were asked to undergo a second mammogram. Following the six-year screening, the incidence of invasive breast cancer was still 22 percent higher in the previously-screened group that in the control group. Because breast cancer risk factors were established as consistent across both groups, Zahl believes that the results indicate that "some breast cancers detected by repeated mammographic screening may not persist to be detectable by a single mammogram at the end of six years."
From "The Value of Mammograms: Think Again"
Newsweek (11/24/08) Begley, Sharon
Technology
New CT Technology Shows Anorexia Impairs Adolescent Bone Development
By using high-resolution, flat-panel volume computed tomography (CT), Harvard Medical Prof. Miriam A. Bredella and her team were able to detect bone structure changes in patients with anorexia that were not identifiable using dual energy x-ray absorptiometry (DSA). Dr. Bredella and her colleagues performed DXA and CT on 10 adolescent girls, aged 13 to 18 years with mild anorexia, and 10 age-matched healthy controls. They found that while there was not a significant difference in bone mineral density between the two groups, the girls with anorexia displayed significant structural differences. The full results of the study can be found in the December issue of Radiology.
From "New CT Technology Shows Anorexia Impairs Adolescent Bone Development"
Doctor's Guide (11/18/08)
Proton Therapy and Concurrent Chemotherapy May Reduce Bone Marrow Toxicity
A new study, led by M. D. Anderson's Division of Radiation Oncology Prof. Ritsuko Komaki, MD, shows that chemotherapy and proton beam therapy may reduce bone marrow toxicity compared to the standard treatment of intensity-modulated radiation (IMRT) and concurrent chemotherapy. Researchers compared bone marrow toxicity levels in 142 patients treated for lung cancer between January 2003 and June 2008. All patients had received chemotherapy, but 75 received IMRT and 67 received proton beam therapy. After 17 months, patients treated with proton beam therapy experienced less reduction in hemoglobin (0 percent vs. 4 percent), neutrophils (4 percent vs. 17 percent), and lymphocytes (54 percent vs. 87 percent) compared to those treated with IMRT. The study was reported at the 2008 Chicago Multidisciplinary Symposium in Thoracic Oncology.
From "Proton Therapy and Concurrent Chemotherapy May Reduce Bone Marrow Toxicity"
Science Centric (11/14/2008)
Diagnostic Performance of Coronary Angiography by 64-Row CT
A study of patients with suspected coronary artery disease suggests that multidetector computed tomographic (CT) angiography can accurately identify the presence and severity of obstructive coronary artery disease. However, a positive predictive value of 91 percent and a negative predictive value of 83 percent show that it cannot yet replace conventional coronary angiography. The study enrolled 291 patients from nine centers, who had undergone multidetector CT angiography before conventional coronary angiography. The research team, led by Julie M. Miller, MD, of Johns Hopkins University School of Medicine, used the area under the receiver-operating-characteristic curve to evaluate diagnostic accuracy, and used the modified Duke Coronary Artery Disease Index to evaluate disease severity.
From "Diagnostic Performance of Coronary Angiography by 64-Row CT"
New England Journal of Medicine (11/27/08) Vol. 359, No. 22, P. 2324; Miller, Julie M.; Rochitte, Carlos E.; Dewey, Marc
Medical-Legal Issues
Congress Introduces Bill Designed to Improve Pricing Transparency for Medical Devices
U.S. Sens. Charles Grassley (R-Iowa) and Arlen Specter (R-Penn.) recently introduced a bill designed to improve transparency in pricing of medical devices considered physician preference items (PPIs). The bill requires manufacturers to report mean and median prices for devices and bundled services to the U.S. Centers for Medicare and Medicaid Services (CMS). Supporters of the bill are hopeful that it will help hospitals make better-informed decisions about the cost and effectiveness of PPIs and to negotiate lower prices. Currently, many medical device manufacturers use strict secrecy clauses in their pricing contracts with hospitals, which prevents the hospital from disclosing price information for PPIs to a third party. Industry insiders say this bill, or an outright ban on such secrecy clauses, would discourage manufacturer's efforts to improve their bottom line through opaque pricing. However, even if the bill is not passed, there are still some limited sources for PPI information including the New York State University Hospital System, the Veterans Health Administration, and some group-purchasing organizations. Additionally, if the bill is passed, experts say it will not solve all the problems associated with PPI purchasing. Experts recommend that a national program comparing the effectiveness of drugs, devices and care processes be established to improve PPI market functionality. Initiatives sponsored and executed by hospitals, medical staff, and professional groups also could help.
From "The Consequence of Secret Prices: The Politics of Physician Preference Items"
Health Affairs (Quarter 4, 2008) Vol. 27, No. 6, P. 1560; Lerner, Jeffrey C.; Fox, Daniel M.; Nelson, Todd
Clinical Practice
New England Journal of Medicine Study Finds 13 Percent of Physicians Currently Use EHR Systems
A recent study in the New England Journal of Medicine indicates that just 13 percent of the nation's physician practices have implemented basic electronic health records systems. The study shows that more advanced systems that permit orders of lab tests and medical imaging procedures, electronic prescriptions, and alerts of drug interactions, among other things, were in use at just 4 percent of practices. Additionally, the report shows that primary care physicians, large practices, and practices in existence for less than 30 years were more likely to have implemented electronic health records. Experts attribute such statistics to the fact that electronic health records systems can cost practices over $50,000 upfront and about $10,000 per physician per year for maintenance. Those that began practicing medicine before electronic systems became available are less likely to shell out that much money when they believe the system they have used for years is adequate. However, experts believe the move to electronic health records is necessary in minimizing medical errors and allowing patients to play a bigger role in managing their care.
From "Digital Doctoring: Your Electronic Health Record, A Blessing or a Curse?"
HealthNews (11/08) Presant, Cary
Radiologists Fear Universal Healthcare May Negatively Affect Their Incomes, USA
Fifty-two percent of radiologists believe universal healthcare could potentially have a negative impact on their practices' revenues, according to a recent survey conducted by physician-recruiting firm LocumTenens. Conversely, of the 200 radiologists surveyed, 39 percent believe universal healthcare would have no affect on their incomes and 9 percent said that universal healthcare could have a positive impact. Additionally, 42 percent of radiologists surveyed offered negative comments regarding universal healthcare's potential impact on physician practices. Respondents also answered questions regarding their current incomes. In 2008, the average salary for diagnostic radiologists was $367,907, which represents a 7 percent increase over the 2007 figure of $343,300. Those salaries are employer-based for 27 percent of respondents, while 28 percent said they are paid on a contract basis and 33 percent are in private practice.
From "Radiologists Fear Universal Healthcare May Negatively Affect Their Incomes, USA"
Medical News Today (11/24/08)
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