Submit Abstracts for RSNA 2009
Now is the time to submit your abstract to be considered for presentation at RSNA 2009. The submission deadline is 12:00 p.m. Central Time on April 15. Abstracts are required for scientific papers, scientific posters and education and applied science exhibits.
To submit an abstract online, go to RSNA.org/abstracts.
More information about RSNA 2009, including registration and course enrollment dates, is available at RSNA2009.RSNA.org .
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Research
Technology
Medical-Legal Issues
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Leading the News
New Payment Formula Proposes Medicare Cuts for High-Tech Imaging
The Medicare Payment Advisory Committee (MedPAC) has recommended a new set of changes for the Medicare Physician Fee Schedule. According to MedPAC's report to Congress, the changes would increase the assumed utilization rate for calculating practice expense RVUs for the technical portion of reimbursement from 25 hours per week to 45 hours per week. These changes would apply to all diagnostic imaging equipment costing more than $1 million. If passed, these changes have the potential to reduce technical payments for MRI, CT, and PET from the Medicare Physician Fee Schedule by as much as 44 percent. MedPAC officials say these changes are designed to reduce the incentive for providers to purchase and use CT, MR, and PET-CT systems. A 2006 survey, sponsored by MedPAC, found that the average hours of use for CT and MRI was 40 hours and 46 hours respectively. However, Pam Kassing, senior director of health economics and health policy for the American College of Radiology (ACR), voiced concern over the proposed changes saying the survey was not "based on solid data." As an alternative to these changes, the ACR recommends CMS consider the results of the American Medical Association's Practice Cost Survey as well as the MedPAC findings. In addition to the fee schedule changes, MedPAC proposed that the Department of Health and Human Services collect and report information related to physician investment in hospitals and other healthcare provision facilities to determine if physician ownership has any effect on referrals, quality, volume, and spending.
From "New Payment Formula Proposes Medicare Cuts for High-Tech Imaging"
Diagnostic Imaging (03/05/09)
Research
Incidental Findings in Trauma Patients Spark Concerns for Physicians
Incidental findings are present in 18.3 percent of patients who undergo CT as part of an initial trauma evaluation, according to a recent study led by Dr. Shella Farooki of Columbus Radiology Corp. Farooki and colleagues analyzed the medical records of 1,256 patients who underwent CT of the cervical spine during an initial trauma evaluation. Of those patients, 230 had incidental findings. The researchers also found that the older the patient, the more likely he or she was to have incidental findings as well as traumas associated with falls.
From "Incidental Findings in Trauma Patients Spark Concerns for Physicians"
Science Centric (03/04/2009)
MRI, PET/CT Improve Optimal Treatment in Patients With Cervical Cancer
Pretreatment MR imaging and positron emission tomography (PET) with CT can help patients make better choices with regards to their therapy for cervical cancer, according to a recent study led by Dr. Pari Pandharipande of the Institute for Technology Assessment. Their work, published in the American Journal of Roentgenology, found that although imaging may not improve survival, PET/CT resulted in 89 percent of patients receiving current primary therapy, while use of both MRI and PET/CT allowed 95 percent of patients to avoid trimodality therapy.
From "MRI, PET/CT Improve Optimal Treatment in Patients With Cervical Cancer"
Doctor's Guide (03/03/09)
NCRP Report Finds Americans Are Exposed to Higher Radiation Levels From Diagnostic Scans
A report released by the National Council on Radiation Protection and Measurement indicates that Americans are exposed to seven times more radiation from diagnostic scans than they were in 1980. These findings have raised concerns that patients may undergo unnecessary scans due to an increasing number of non-radiologists that have purchased imaging equipment for their practices. To ensure diagnostic scans only are performed when necessary, radiologist groups, including the American College of Radiology, currently are working to craft appropriate-use standards.
From "Overexposed: Imaging Tests Boost U.S. Radiation Dose"
Reuters (03/04/09) Steenhuysen, Julie
MR Imaging Helps Avoid Radiation Exposure for Pregnant Women Suspected of Having Acute Appendicitis
Researchers, led by Dr. Ivan Pedrosa of the Harvard Medical School Department of Radiology, found that MR imaging is able to provide favorable combinations of negative laparotomy rate and perforation rate in pregnant women suspected of having acute appendicitis, allowing physicians to avoid the radiation exposure associated with CT examination in the majority of cases. These findings are based on 148 pregnant patients who were clinically suspected of having acute appendicitis and examined with MR imaging between March 2002 and August 2007. Of those patients, 10 percent had acute appendicitis, and perforation occurred in 21 percent of them, or three patients. MR results were positive in all patients with acute appendicitis and were negative in 125 of the 134 without acute appendicitis.
From "Pregnant Patients Suspected of Having Acute Appendicitis: Effect of MR Imaging on Negative Laparotomy Rate and Appendiceal Perforation Rate"
Radiology (03/01/09) Vol. 250, No. 3, P. 749; Pedrosa, Ivan; Lafornara, Michelle; Pandharipande, Pari V.
Technology
Unenhanced CT Plus MR Imaging Improves Accuracy for Distinguishing Between TDL and Primary Brain Tumors
Unenhanced CT plus MR imaging is more accurate than MR imaging alone for distinguishing tumefactive demyelinating lesions (TDLs) from primary glioma or central nervous system lymphoma, according to study led by Seoul National University Prof. Dae Sik Kim. This conclusion was based on by retrospectively reviewing unenhanced CT and MR images in patients with TDLs or primary brain tumor. The review indicated that the diagnostic accuracy of CT was 95 percent, compared to 63 percent for unenhanced T1-weighted MR imaging.
From "Distinguishing Tumefactive Demyelinating Lesions From Glioma or Central Nervous System Lymphoma: Added Value of Unenhanced CT Compared With…"
Radiology (03/04/09) Kim, Dae Sik; Na, Dong Gyu; Kim, Keon Ha
Study Finds Sonohysterography Is an Appropriate Alternative Diagnostic Tool for Women With Adenomyosis
Recent research performed at the Thomas Jefferson University Hospital indicates that sonohysterography (SHG) may improve the diagnostic potential of transvaginal ultrasound in detecting adenomyosis. The study, led by Dr. Sachit Verma, included 26 women who underwent SHG and MRI of the pelvis and in whom either modality suggested adenomyosis. Of those women, 88 percent had SHG findings suggestive of adenomyosis, while the remaining 12 percent had adenomyosis identified on MRI performed after sonohysterography. Full results of the study will be published in the April issue of the American Journal of Roentgenology.
From "Sonohysterography Is an Alternative Diagnostic Tool for Women With Adenomyosis"
Science Daily (03/04/09)
Medical-Legal Issues
Medical Imaging Policies Create Concern for Physicians Who Perform Imaging Services
The federal government's policies on medical imaging are in a state of flux as officials attempt to find ways to reduce rising healthcare costs without jeopardizing patient access to essential diagnostic procedures. In 2007, the Centers for Medicare and Medicaid Services imposed a Medicare fee structure that caps spending on imaging services at $12.1 billion. Although this cap has been found to reduce Medicare's imaging expenditures in 2007, the use of imaging services has continued to accelerate. In 2008, Congress instituted regulations that require all advanced imaging tests to be performed by an accredited radiologist, as of 2012. At that time, Congress also mandated that the Department of Health and Human Services create a pilot program to assess the appropriate use of imaging services. More controversially, however, are new Government Accountability Office-supported Medicare regulations that will require prior authorization for advanced imaging procedures. A large percentage of physicians has responded negatively to prior authorization--which is already used by many private insurers--because of concerns that it interferes with their ability to make appropriate clinical decisions for their patients. Additionally, Congress seems to be moving toward stricter evidence-based requirements for imaging procedures. In light of these changes, medical providers and suppliers alike are expected to be affected by the government's renewed efforts to reduce Medicare spending. The imaging community is reacting to these efforts through two primary strategies: to maintain that Medicare fees to physicians who perform imaging services have already been reduced substantially by the Deficit Reduction Act of 2007, and to demonstrate that professional imaging societies are working on standards that will ensure appropriate use of advanced imaging modalities.
From "Health Insurers and Medical-Imaging Policy: a Work in Progress"
New England Journal of Medicine (03/05/09) Vol. 360, No. 10, P. 1030; Inglehart, John K.
Clinical Practice
FDA Warns About Risk of Wearing Medicated Patches During MRIs
The FDA has issued a public health advisory regarding the use of transdermal drug patches during MRI. The advisory was issued after the agency found that the labeling for some types of transdermal patches that contain aluminum or other metals in their non-adhesive backing do not include warnings against their use in patients undergoing MRI. The FDA has received reports of patients wearing the patches during an MRI scan receiving skin burns at the patch site.
From "FDA Warns About Risk of Wearing Medicated Patches During MRIs"
FDA.gov (03/05/09)
Customer Satisfaction Surveys Increase Quality of Care
Customer service surveys can provide radiology practices with a better look at patient needs to significantly improve quality of care. Patient satisfaction surveys help practices evaluate their strengths and weaknesses while also helping patients feel included in all aspects of their care. Patient experiences tend to hinge on little details--those that may be easily fixed but that can make all the difference in the world. Common practices that have been found to increase patient satisfaction with their imaging experience include having the procedure explained to them carefully and treating the patient with overall care and kindness throughout their time at the facility.
From "Surveying the Situation"
Advance (03/03/09) Casañas, Jorge R.; Cossio, Robert
RSNA Weekly is a briefing of the latest radiology-related news selected from hundreds of sources by the editors of Information, Inc. While care is taken to use good sources, inaccuracies in source material are not the responsibility of RSNA or Information, Inc.
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