New Days for Financial Seminars at RSNA 2009
Two investment seminars will be offered at RSNA 2009. “Effective Real Estate Investment Strategies,” will be presented by J. Michael Moody, M.B.A. on Saturday, Nov. 28, and “Asset Protection and Retirement Planning in the New (Stimulus?) Era,” will be presented by Barry Rubenstein, B.S., J.D., L.L.M., on Monday, Nov. 30.
This year’s new two-day format offers attendees more flexibility.
In challenging financial times, these simple and direct educational seminars specifically tailored for the medical professional will provide RSNA 2009 attendees with the tools necessary to achieve real estate and investment goals.
For more information, click here.
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Leading the News
Research
Technology
Medical-Legal Issues
Clinical Practice
From RSNA
Featured in RadioGraphics: Best Cases from the AFIP
In a new case from the Armed Forces Institute of Pathology, learn more about the clinical imaging and pathologic evaluation of osmotic demyelination syndrome.
According to the article, imaging findings of osmotic demyelination syndrome typically lag behind clinical symptoms and images acquired within 1–2 weeks after the onset of symptoms often show no features of the disease. Imaging performed after symptoms have been present for 2 weeks has been advocated to help confirm the diagnosis, although osmotic demyelination syndrome cannot be excluded with imaging alone.
Read more about “Osmotic Demyelination Syndrome,” by Stephanie A. Howard, M.D. and colleagues, in the current issue of RadioGraphics.
Leading the News
CT Colonography Aids Detection of Advanced Neoplasia in Individuals at Increased Risk of Colorectal Cancer
Researchers have established that CT colonography has a negative predictive value of 96.3 percent in patients who have a high risk of developing colorectal cancer (CRC) when compared to traditional colonoscopy. Daniele Regge, MD, of the Institute for Cancer Research and Treatment in Turin, Italy, and colleagues used both CT colonography and colonoscopy on 937 patients with CRC risk factors, including family history, personal history of adenomas, and a positive fecal occult blood test (FOBT). Overall, CT colonography identified 151 out of 177 participants with advanced neoplasia 6 mm or larger. It also correctly classified 760 participants without such lesions. Based on these figures, the researchers also established that CT colonography has a negative predictive value of 84.9 percent, specifically in patients with a positive FOBT.
From "Diagnostic Accuracy of Computed Tomographic Colonography for the Detection of Advanced Neoplasia in Individuals at Increased Risk of Colorectal Cancer"
Journal of the American Medical Association (06/17/09) Vol. 301, No. 23, P. 2453; Regge, Daniele; Laudi, Christiana; Galatola, Giovanni
Research
RI Predicts Unfavorable Outcomes in Patients With Chronic Nephropathies
A renal resistive index (RI) of over 0.70 is predictive of an unfavorable outcome in patients with chronic nephropathies, according to a study published at Radiology Online on June 15, 2009. For the purposes of the study, correlations were established between initial RI and age, estimated glomerular filtration rate (eGFR), proteinuria, hematuria, blood pressure, and biopsy scores. Participants were then categorized based on initial RI and eGFR values and compared with progression to renal failure. The researchers determined that RI was the only independent risk factor for the progression of renal failure.
From "Renal Resistive Index and Long-Term Outcome in Chronic Nephropathies"
Radiology Online (06/15/09) Parolini, Claudia; Noce, Annalisa; Staffolani, Emiliano
PET Scans Improve Accuracy of Dementia Diagnosis
The accuracy of dementia diagnosis could be improved by positron emission tomography (PET) scans for one out of four patients, according to a new study. The study involved the identification of 66 patients with mild dementia or mild cognitive impairment who were assessed with standard neurological testing and anatomic brain imaging. A trio of clinical experts reviewed the results of this data to diagnose either Alzheimer's disease, frontotemporal dementia, or dementia with Lewy bodies. Afterwards, patients were subjected to PET scanning for amyloid deposits and for dopamine nerve integrity. Patients' initial diagnoses changed over a quarter of the time following PET imaging. The scans yielded images of important disease indicators overlooked by other examinations, including amyloid plaque deposits and dopamine nerve damage. "Routine clinical assessments do not accurately identify the root causes of dementia in the early stages," said lead study author and physician Kirk A. Frey with the University of Michigan Hospitals' Division of Nuclear Medicine. "Our preliminary results clearly indicate that molecular imaging technologies, such as PET scans, can help diagnose a patient's specific type of dementia. This is critical for providing the best possible care. Additionally, PET's ability to pinpoint neurological underpinnings of different forms of dementia could lead to new, more targeted drugs and therapies." The results of the study were presented at the Society of Nuclear Medicine's 56th Annual Meeting.
From "PET Scans May Improve Accuracy of Dementia Diagnosis"
Science Daily (06/15/09)
Technology
Scan Provides High-Quality Images of Small Tumors
A combination of high resolution and high sensitivity collimation yields better quality images when using single photon emission computed tomography (SPECT) scans, according to the results of a new study presented at the Society of Nuclear Medicine's 56th Annual Meeting. "SPECT is an important tool in molecular imaging because of its ability to provide accurate images of what is going on in the body without the need for invasive procedures such as surgery," said lead study author Roel Van Holen with Belgium's Ghent University. "However, researchers have had to make tradeoffs in SPECT image quality, especially in imaging very small tumors. Our research is exciting because it shows that combining high-resolution and high-energy collimators can improve SPECT's ability to image small tumors." Collimators are employed in SPECT because it is still impossible to concentrate radiation with such short wavelengths into an image using lenses. It has been established by researchers that SPECT image quality is generally enhanced with the use of collimators with greater sensitivity than traditional low-energy high-resolution (LEHR) collimators, yet LEHR actually produces better images in cases where small tumors are being imaged. The new study involved combining a high-resolution collimator with a high-sensitivity collimator. The GATE Monte Carlo simulator was used to simulate a dual-head SPECT camera with three different collimator settings, and the results showed that SPECT image quality was better with the blended collimation than it was by using only high-resolution or only high-sensitivity collimation.
From "Scan Provides High-Quality Images of Small Tumors"
RedOrbit (06/15/09)
Researchers Investigate Potential Uses for Photoacoustic Tomography
Photoacoustic tomography theoretically can provide cheap, convenient scans comparable to those generated by magnetic-resonance imaging (MRI) or x-ray computerized tomography (CT) through the method's integration of optics and ultrasonic imaging. A photoacoustic image is created by shining laser light pulses onto the tissue being scanned - heating the tissue enough to cause the cells to expand and contract, emitting ultrasonic sound waves picked up by sensors on the skin. A computer then converts these signals into a two- or three-dimensional image of the underlying structure using a process of triangulation. Washington University photoacoustic researcher Lihong Wang says that MRI and CT scans are not only very expensive, but they also require the injection of contrast dyes into the patient's bloodstream in order to yield comparable images. Photoacoustic tomography, however, could eventually be carried out by handheld devices. Cancer treatment is one of the most promising applications for photoacoustics, as the technique is especially effective at producing high-contrast images of blood vessel formation and identifying higher metabolic activity, which Wang says are indications of cancer. He believes that if contrast agents that are too minute to be detected by ordinary ultrasound were injected into a patient's bloodstream, they could be spotted via photoacoustic imaging. Additionally, it would be possible to view a buildup of contrast agents to determine the extent of a tumor.
From "The Sound of Light"
Economist (06/12/09) Vol. 391, No. 8634, P. 27
Wii Helps Radiologists Boost Efficiency
The Nintendo Wii's motion-sensitive wireless controller could help radiologists boost efficiency and surgeons boost their skills. The Wii is being used by physicians at New York-Presbyterian Hospital/Weill Cornell Medical Center to help scan through an ever-mounting workload of patient x-ray and magnetic resonance imaging pictures. With the controller, a user can cycle through scans by rotating the wrist instead of navigating through images for hours via basic keyboard and mouse clicks. This reduces the likelihood of carpal tunnel syndrome and other repetitive motion injuries. "The remote is very intuitive," says Weill Cornell Medical College radiologist George Shih. He and his colleagues helped create the system through which the Wii remote is connected to the diagnostic computer. The technology could also benefit surgeons. "With the Wii, we have a very easy and inexpensive platform where surgery residents can learn and develop their skills," says Banner Good Samaritan Medical Center endoscopic surgeon Mark Smith.
From "Powerful Ideas: Wii Aids Doctors and Patients"
LiveScience (06/17/09) Choi, Charles Q.
Medical-Legal Issues
Senator Introduces Legislation to Increase MedPAC's Power Over Physician Reimbursement
Sen. John Rockefeller (D-W.Va.) has introduced legislation that would establish the Medicare Payment and Access Commission (MedPAC) as an independent executive body. Currently, MedPAC is a legislative entity that makes recommendations to Congress regarding Medicare payment policies, but it has no power to implement those recommendations and Congress often disregards its advice. As an executive body, MedPAC would have independent authority to establish payment policies. In turn, Congress would increase its oversight of the commission and commissioners would have to be confirmed by the Senate.
From "Some in Congress Want to Boost MedPAC's Power Over Pay"
American Medical News (06/15/09)
Actual Imaging Use Falls Below CMS Utilization Recommendations for Medicare
The Obama administration recommends that the Centers for Medicare and Medicaid Services (CMS) base imaging reimbursement on a 95 percent usage rate, but data compiled by the Radiology Business Management Association (RBMA) indicates that imaging equipment utilization rates do not even come close to this number. The data illustrates that imaging equipment in rural U.S. areas operates only 48 percent of the time an office is open, while equipment in non-rural areas functions 56 percent of the time a center is open for business. At present, CMS assumes that imaging equipment is in use 50 percent of the available time on average when calculating its reimbursement formula for diagnostic imaging services. The RBMA data suggests that the current Medicare utilization rate is close to the actual rate at which imaging equipment functions. The drastic elevation of the utilization assumption to a level significantly higher than actual use rates would entail a dramatic cut for imaging reimbursements that will hinder access to diagnostic imaging services and cause patients to postpone or skip required imaging procedures. A recent Moran Company analysis estimates that Medicare spending on advanced imaging fell by a little more than 19 percent from 2006 to 2007. Meanwhile, volume of these services increased by nearly 2 percent following the reduction of imaging reimbursements by the Deficit Reduction Act of 2005. Spending for all imaging services declined 13.3 percent from 2006 to 2007, and a 40 percent drop in Medicare reimbursements for dual-energy x-ray absorptiometry was recorded in the same period.
From "Actual Imaging Use Far Below President's Rec. 95 Percent Utilization Rate for Medicare"
EurekAlert (06/18/09)
Clinical Practice
New Group Seeks Incentives for Electronic Ordering
The Imaging e-Ordering Coalition is a newly established lobbying organization that wants lawmakers to make a broader effort to build incentives for providers to embrace electronic prescribing technology for medication that also includes electronic ordering systems for diagnostic imaging processes. The goal is to do for e-ordering of diagnostic imaging what e-prescribing has done for the drug prescription process - verify that treatment decisions made by physicians are medically appropriate and safe without compromising the physician-patient relationship. The group has established several additional goals, most aimed at addressing the radiology industry’s concern over the growing use of radiology benefits managers. Those goals include acting as a resource for the CMS on the Medicare imaging demonstration project that was mandated as part of the Medicare Improvement Act of 2008 and working with radiology stakeholders to set e-ordering standards.
From "New Group Seeks Incentives for Electronic Ordering"
Modern Healthcare (06/16/09) Rhea, Shawn
RADAR Task Group Announces New Tool for Nuclear Medicine Patient Release Calculations
The development of a new tool for nuclear medicine patient release calculations was announced by three members of the Society of Nuclear Medicine Radiation Dose Assessment Resource (RADAR) task group in April. The RADAR Exposure Calculator can be utilized in other clinical situations involving various cases of external radiation exposure in which the estimation of radiation dose to others may be necessary. The calculator was devised as a response to comments and concerns about current requirements related to the release of patients who have received doses of radiation. The online software tool involves more realistic calculations that permit higher releasable activity levels than the NUREG levels, especially for patients receiving treatment for thyroid cancer. RADAR attests that professionals assessing compliance with Nuclear Regulatory Commission requirements for patient release should employ the procedures presented on the dose calculator Web site and not depend automatically on NUREG-1556. Dose calculator users can input any values for the calculation variables, although default values are supplied for certain variables.
From "New Tool for Nuclear Medicine Patient Release Calculations"
Journal of Nuclear Medicine (06/09) Vol. 50, No. 6, P. 14N; Stabin, Michael; Marcus, Carol; Siegel, Jeffry
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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