News of RSNA 2008 Available Online
Did you miss RSNA 2008 in Chicago? Are you an attendee wanting to relive fond memories? Catch up on meeting news through the RSNA 2008 Daily Bulletin at www.RSNA.org/bulletin.
Headlines
Leading the News
Research
Technology
Clinical Practice
Leading the News
Latest Breast Imaging Techniques Offer New Views
Two new breast imaging techniques may improve breast cancer diagnosis, according to two studies presented at RSNA's annual meeting in Chicago. The first technique, known as positron emission mammography (PEM) was presented by Boca Raton Community Hospital director of breast imaging Dr. Kathy Schilling. Her team's research, found that PEM was able to detect cancer in 100 percent of fatty breasts, 93 percent of dense breasts, and 85 percent of extremely dense breasts. Cancer was also accurately detected in 93 percent of women regardless of whether or not they used hormone replacement therapy, 90 percent of pre-menopausal women, and 94 percent of postmenopausal women. According to Dr. Schilling, these results are similar to MRI testing; however, PEM may not carry the same risk of false positives often associated with MRIs. The second study, led by George Washington University's Dr. Rachel Brem, investigated the accuracy of breast-specific gamma imaging (BSGI). Brem and her colleagues reviewed data from 151 women who had been found to have suspicious lesions following mammography. These women then underwent BSGI, which detected an additional 29 suspicious lesions, one-third of which were found to be cancerous.
From "Latest Breast Imaging Techniques Offer New Views"
U.S. News & World Report (12/03/08) Gordon, Serena
Research
Patients' Photos Help Boost Radiologists' Accuracy
Having a patient's photo in his or her file may help radiologists feel more empathetic and improve accuracy when reading medical images, according to a recent study. In the study, radiologists reviewed patients' electronic files through a picture archiving and communication system (PACS), which automatically showed the patient's photograph. All the radiologists in the study said they felt more empathy toward the patients after seeing their pictures. When the radiologist re-examined the files three months later, with the patient's photograph left out, an average 80 percent of the radiological findings originally reported were not reported the second time. The researchers, led by Dr. Yehonatan N. Turner, radiology resident at Shaare Zedek Medical Center in Jerusalem, presented the findings at the annual meeting of the RSNA in Chicago. Turner said the study emphasizes the importance of seeing the patient as a human being instead of an anonymous case.
From "Patients' Photos Help Boost Radiologists' Accuracy"
Washington Post (12/02/08)
Some MRIs May Harm Cochlear Implants
The 3T MRI machine can demagnetize cochlear implants, according to a study led by researchers at the Medical University of Hanover. The researchers tested a 3T MRI scanner with active shielding at a variety of angles on cochlear device magnets. They found that routine use of 3T MRI at angles above 80 degrees can cause permanent damage to non-removable magnets. The researchers recommend that patients with cochlear implants only undergo 3T MRI if a 1.5T machine is unavailable and if the benefits of the scan far outweigh the risk of implant demagnetization.
From "Some MRIs May Harm Cochlear Implants"
United Press International (12/02/08)
Sonography Detects Fat Necrosis in Extremity and Torso
Sonography can detect isolated fat necrosis in the extremity and torso, according to a study conducted by researchers at the University of Michigan Medical Center. The team, led by Dr. Michael Walsh, found five cases of primary fat necrosis, two of which were evaluated by MRI, in the Department of Pathology Database. Sonograms were reviewed by two musculoskeletal radiologists. Patient medical records, histologic results, and MRI findings were also reviewed. Of the five cases of isolated fat necrosis, two involved the torso and three involved the lower extremities. On sonography, all were located in the subcutaneous fat. Two of these were isoechoic while three were hyperechoic, and two had a hypoechoic halo. Additionally, MRI showed an intermediated signal and either diffuse or ring enhancement.
From "Sonography of Fat Necrosis Involving the Extremity and Torso With Magnetic Resonance Imaging and Histologic Correlation"
Journal of Ultrasound in Medicine (12/01/08) Vol. 27, No. 12, P. 1751; Walsh, Michael; Jacobson, Jon A.; Kim, Sung Moon
Technology
CT Colonography Screens for Cancer, Osteoporosis
CT colonography may be able to provide radiologists with an accurate bone density measurement, according to a study led by University of California San Francisco clinical professor of radiology Rizwan Aslam. For their research, reported at RSNA's annual meeting in Chicago, Aslam and his team performed CT colongraphy on 35 patients. The conclusions drawn from these images were found to match traditional DEXA bone mineral density scores.
From "CT Colonography Screens for Cancer, Osteoporosis"
Washington Post (12/02/08)
PET Is Most Powerful Imaging Tool in Cancer Management, Nationwide Study Confirms
An analysis of the most recent results from the National Oncologic PET Registry (NOPR) found that positron emission tomography (PET) has a clinically significant impact on cancer management, resulting in a change in treatment in 36 percent of patients. The study, conducted by Virginia Commonwealth University Prof. Bruce E. Hillner and his team, reviewed data collected from nearly 41,000 PET studies from the NOPR. The full results of the analysis can be found in the Journal of Nuclear Medicine. Because of the consistency of detection rates across different cancer types, the researchers hope the data will encourage the Centers for Medicare and Medicaid Services (CMS) to expand PET coverage to include cancers not currently eligible for reimbursement. CMS is expected to release a draft decision regarding PET reimbursement for cancers of the ovary, uterus, prostate, pancreas, stomach, kidney, and bladder on Jan. 10, 2009.
From "PET Is Most Powerful Imaging Tool in Cancer Management, Nationwide Study Confirms"
Science Daily (12/07/08)
Portable Scanners Could Save Lives for Patients With Strokes
The use of a portable eight-slice CT to diagnose acute ischemic strokes in emergency department (ED) settings may improve the number of patients treated with thrombolytic therapy within the recommended three-hour window by 86 percent, according to a study presented at RSNA's annual meeting. The study, led by Dr. David B. Weinreb, used a portable CT scanner to assess stroke patients in the ER of NSMC-Salem Hospital. Weinreb and his colleagues tracked how much time elapsed between a physician's order for a head CT and the scan for one month prior to the acquiring of the portable CT and four months afterwards. They found the CT scanner in the ED reduced the time between the order and the exam by 54 percent, from 34 minutes to 15 minutes.
From "Portable Scanners Could Save Lives for Patients With Strokes"
Healthcare IT News (12/02/08) Monegain, Bernie
Clinical Practice
Electrical, IT Must be Considered in New Equipment Purchases
Digital imaging technologies are constantly changing as new equipment and modalities improve image resolution for diagnostics, treatment, and intervention. When investing in these new technologies, many healthcare facilities focus primarily on the costs of the new equipment, forgetting the electrical and information technology (IT) infrastructure necessary to ensure they operate effectively. Before purchasing new imaging equipment, there are several infrastructure issues facilities need to address such as the impact on the IT closets that power servers and network switches that support digital imaging. Experts say that, if at all possible, digital imaging equipment should be served by a dedicated power distribution branch off the facility's main electrical service. This helps isolate digital imaging equipment in case of power fluctuations because many advanced imaging technologies are extremely sensitive to those types of disturbances. Additional power supply also must be considered if the facility plans to institute picture archiving communication systems (PACs).
From "Digital Imaging and the Future"
Medical Construction & Design (12/08) Vol. 4, No. 6, P. 22; Leonidas, Tom
Group Purchasing Organizations Gaining Popularity
More healthcare organizations are choosing to purchase advanced imaging equipment such as MRI and CT scanners through group purchasing organizations (GPOs). According to Novation, facilities participating in the GPO's annual group-buy event increased more than 50 percent between 2007 and 2008. Experts say the increased interest in group-buy agreements and other alternative financing options for imaging equipment is largely due to the scarcity of capital access caused by the recession. Additionally, many healthcare providers anticipate reduced reimbursement from Medicare and other payors for certain imaging procedures. Other alternative financing arrangements include captive and third-party leasing. Captive leases allow healthcare facilities to acquire equipment directly from the imaging vendor, while third-party agreements require an outside financial institution to purchase the equipment and lease it to the hospital. Both types of leases have their advantages. Captive leases often encourage vendors to include add-ons such as extended service warranties and training assistance to support equipment sales. On the other hand, third-party lessors are often more flexible when negotiating interest rates. Leasing is often more appealing to facilities because it allows them to trade in the equipment for a more-advanced model. This option is particularly important when it comes to fast-developing technologies such as CT and PET scanning.
From "Drawing High Interest"
Modern Healthcare (12/01/08) Vol. 38, No. 48, P. 36; Shawn, Rhea
Radiologists Use Digital Imaging to Improve Mammography Access
Aging baby boomers have radiologists and hospital leaders concerned about a growing demand for mammograms, but several changes have been able to prevent an access crisis. A 2003 study published in Radiology that said two-thirds of radiology residents would not even consider a fellowship in breast imaging. In 2005, a 20-week wait for a woman to receive a routine screening mammogram was not uncommon, said Linda Hansen-Allen, director of women's imaging at Baptist Health of Northeast Florida. At Baptist Health, changing to digital from analog mammography eliminated screening backlog, and allowed the health system to consolidate the service into one center, where radiologists work in close proximity and assistants help with logistics. Other hospitals have made similar changes, such as South Nassau Communities Hospital, which opened a breast imaging center that offers digital imaging, extended hours, and sometimes walk-ins. Digital imaging has allowed for a 12 percent increase in mammograms between 2000 and 2007, even as the number of facilities decreased 11 percent in the past four years, said Brian Baker, senior vice president of Tennessee's Regents Health Resources, citing FDA data. The technological advances may also have contributed to an increased interest in breast imaging among residents, according to Lawrence Bassett, MD, the Iris Cantor professor of breast imaging at UCLA's David Geffen School of Medicine. While digital screening units require greater initial investment, between $400,000 and $450,000, the reimbursement is about $130, compared to about $50 with analog.
From "Mammography Rebounds"
Hospitals & Health Networks (11/08) Huff, Charlotte
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