RSNA 2009 Financial Seminars Tame the New Economy
Two investment seminars will be offered at RSNA 2009:
- Saturday, Nov. 28 - “Effective Real Estate Investment Strategies,” presented by J. Michael Moody, M.B.A.
- Monday, Nov. 30 - “Asset Protection and Retirement Planning in the New (Stimulus?) Era,” presented by Barry Rubenstein, B.S., J.D., L.L.M.
In challenging financial times, these simple and direct educational seminars specifically tailored for the medical professional will provide the tools necessary to achieve real estate and investment goals.
For more information, click here.
Headlines
From RSNA
Leading the News
Research
Technology
Medical-Legal Issues
Clinical Practice
From RSNA
August RSNA News Now Online
The full version of the August issue of RSNA News is now available online.
Highlights include:
Stereotactic Body Radiotherapy Effective for Treating Spine Tumors
Stereotactic body radiotherapy is a highly effective, minimally invasive alternative treatment for some cancer patients with spine tumors, according to new research from The University of Texas in Houston.
Revised Pediatric Guidelines Aid Radiologists in Detecting Child Abuse
Radiologists facing the grim task of assessing potential child abuse now have newly revised imaging guidelines as part of a new policy statement from the American Academy of Pediatrics that more closely mirror recommendations from the American College of Radiology.
Early Radiology Exposure Could Lure Medical Students to Specialty
Improving perceptions and increasing early efforts to expose medical students to radiology could help counteract recent waning interest in the specialty, according to radiology professors.
Robotic System Aids CT-Guided Needle Biopsy
Lung biopsies and ablations are just some of the procedures that could become less complicated and more precise if a newly designed robotic system that aids in CT-guided needle biopsy earns FDA approval and makes its way into clinical practice.
Chicago Events and Attractions Shine at RSNA 2009 [pdf]
From its world-class museums and bustling theater scene to its delectable dining and family-friendly activities, the city of Chicago offers something for everyone attending RSNA 2009.
Leading the News
CMS to Cover FDG PET for Cervical Cancer Staging, Not Diagnosis
CMS was asked to reconsider Section 220.6 of the National Coverage Determinations Manual to end the prospective data collection requirements for FDG PET for initial staging of cervical cancer. CMS proposes that the evidence is adequate to determine that the results of FDG PET imaging for cervical cancer staging of beneficiaries diagnosed with cervical cancer are used by the treating physician to make meaningful changes in therapeutic management and improve health outcomes, and thus are reasonable and necessary under the Social Security Act. Therefore, CMS proposes to cover only one FDG PET for staging in beneficiaries who have biopsy proven cervical cancer when the beneficiary's treating physician determines that the FDG PET study is needed to determine the location and/or extent of the tumor for the following therapeutic purposes related to the initial treatment strategy: to determine whether or not the beneficiary is an appropriate candidate for an invasive diagnostic or therapeutic procedure; to determine the optimal anatomic location for an invasive procedure; or to determine the anatomic extent of the tumor when the recommended anti-tumor treatment reasonably depends on the extent of the tumor. CMS has also concluded that there is no credible evidence that the results of FDG PET imaging are useful to make the initial diagnosis of cervical cancer. Therefore, the agency will not approve coverage of FDG PET for that purpose.
From "Proposed Decision Memo for Positron Emission Tomography"
CMS Press Release (08/13/09)
Research
Anesthetic Injection Reduces Pain of Sentinel Lymph Node Biopsy
Accompanying radioisotope injections with injections of the anesthetic lidocaine makes sentinel lymph node biopsies substantially less painful without adversely impacting the biopsy's effectiveness, according to the results of a randomized controlled trial administered by Col. Alexander Stojadinovic, MD, of Walter Reed Army Medical Center, and colleagues. The trial involved 140 women with painless but biopsy-validated early stage breast cancer who underwent the sentinel lymph node biopsy. The standard procedure uses only topical lidocaine, and pain scores immediately after subareolar injection using this procedure were 6.0 on a 10-point scale. With a lidocaine injection, however, the pain scores were only 1.6, reported Stojadinovic. His group said that lymph node identification rates did not differ across treatment groups, and no negative events associated with lidocaine injection were observed. Subareolar injection is a fast and effective sentinel lymph node biopsy procedure that precludes the need for image guidance or overlapping radioactivity. The researchers concluded that lidocaine in the radiocolloid preparation "should be considered a new standard of practice." Memorial Sloan-Kettering Cancer Center's Hiram S. Cody III, MD, concurred with this conclusion. "All of us who use technetium-99m-sulfur colloid are well advised to add lidocaine to our injection protocols; many patients will benefit," he wrote in a reaction article. Stojadinovic and colleagues disclosed their findings online ahead of print in the September edition of The Lancet Oncology.
From "Anesthetic Injection Reduces Pain of Sentinel Lymph Node Biopsy"
MedPage Today (08/06/09) Phend, Crystal
Lower-Kilovoltage Coronary CTA Maintains Image Quality
European and Japanese researchers successfully reduced radiation dose by nearly one-third in coronary computed tomography angiography (CTA) studies of all but the heaviest cardiac imaging patients by lowering the kilovoltage from 120 kV to 100 kV, and no discernible difference in image quality was observed. Moreover, the researchers ascertained that the lower kV scans appear to be just as effective at making the clinical determination without requiring additional tests from other imaging procedures. It has been demonstrated that a reduced tube voltage of 100 kV for coronary CTA can effectively lower radiation exposure while maintaining sufficient image quality. Dr. Jorg Hausleiter from Germany's Deutsches Herzzentrum says that 400 patients that weighed less than 90 kilograms or who had a body mass index of less than 30 and stable sinus rhythm were randomized to CTA with a tube voltage of 120 kV or 100 kV. "In terms of image quality, the score was very much the same between the two groups," Hausleiter said. The need for additional clinical tests, the secondary end point, did not differ significantly between the groups, he added.
From "Lower-Kilovoltage Coronary CTA Maintains Image Quality"
AuntMinnie.com (08/05/09) Barnes, Eric
MRI Identifies Differences in Disease Burden and Activity in Pediatric Patients With MS at Time of Onset Compared to Adults
Researchers using MRI were able to identify a number of characteristics associated with worse disability progression in patients with pediatric-onset multiple sclerosis (MS). These characteristics include higher disease burden, posterior fossa involvement, and rate of new lesions in pediatric-onset MS. Researchers established these characteristics after performing MRI scans on 41 patients with pediatric-onset MS and 35 patients with adult-onset MS. By doing so, researchers also observed that pediatric patients had more new T2-bright and gadolinium-enhancing foci than adults.
From "Difference in Disease Burden and Activity in Pediatric Patients on Brain Magnetic Resonance Imaging at Time of Multiple Sclerosis Onset vs. Adults"
Archives of Neurology (08/09) Vol. 66, No. 8, P. 967; Waubant, Emmanuelle; Chabas, Dorothee; Okuda, Darin T.; et al.
Transcranial Doppler Ultrasonography Predicts Cardiovascular Events After TIA
Patients diagnosed with a transient ischemic attack (TIA) and with abnormal transcranial Doppler ultrasonography findings have a high risk of developing further cerebral and cardiovascular ischemic attacks. This conclusion was based on a study of 176 TIA patients. All patients received diffusion-weighted imaging as well as standardized extracranial and transcranial Doppler ultrasonography. Follow-up with patients was then conducted at 27 months and new vascular events were recorded. Extracranial Doppler ultrasonography revealed extracranial stenosis or occlusions in 19.3 percent of patients, while transcranial Doppler ultrasonography detected intracranial stenosis in 9.2 percent of patients and collateral flow patterns due to extracranial stenosis in 3.1 percent of patients.
From "Transcranial Doppler Ultrasonography Predicts Cardiovascular Events After TIA"
BMC Medical Imaging (07/09) Holzer, Katrin; Sadikovic, Suwad; Esposito, Lorena; et al.
Technology
New Procedure Improves Fluorine Injection for Imaging Agents
A new way to inject fluorine into diverse compounds used in many pharmaceuticals has been developed by researchers at the Massachusetts Institute of Technology (MIT). The innovation could make the design of new drugs less expensive and more flexible. "It's hard to add fluorine at a late stage, once you have a complete molecule already put together, because traditional methods can be quite harsh with respect to temperature or other factors," notes MIT chemistry professor Stephen L. Buchwald. The new method devised by Buchwald and colleagues involves the use of a palladium catalyst to attach a fluorine atom to aromatic compounds. During the process, the catalyst extracts a group of atoms called a triflate, and then substitutes a fluorine atom taken from a simple salt. The technique could be employed to produce new imaging agents for positron emission tomography scanning. "While the method is probably not currently efficient enough to be used in manufacturing, we are working to speed up the reaction, increase its efficiency, and make it more environmentally and user-friendly," Buchwald says. "We ultimately hope to make it general enough to be useful for manufacturing." The National Institutes of Health funded the research, which is detailed in the Aug. 13 early online edition of Science.
From "New Way to Prepare Fluorinated Pharmaceuticals"
redOrbit (08/11/09)
Medical-Legal Issues
CDRH Director Resigns
Daniel Schultz, the director of the Food and Drug Administration's (FDA's) Center for Devices and Radiological Health (CDRH), Daniel Schultz, has resigned "by mutual agreement" with FDA Commissioner Margaret Hamburg. FDA officials said the resignation was not related to any specific issues concerning the agency's device-approval process. The CDRH has recently faced criticism that the approval process is too lax and that medical device manufacturers have too much influence on approvals. A group of nine device division employees wrote to the House Energy and Congress Committee in late 2008 that leaders of the CDRH approved devices despite formal safety and efficacy concerns raised by the FDA. They also alleged that agency scientists who objected to approval decisions faced retaliation from leaders of the device division.
From "FDA Medical-Device Regulator Resigns"
Wall Street Journal (08/12/09) Mundy, Alicia
Radiation Oncologists Say Proposed Medicare Cuts Would Close Clinics, Harm Patients
The Centers for Medicare & Medicaid Services (CMS) has announced proposed revisions to the Medicare physician fee schedule that could lead to cuts in payments for radiation cancer therapy services of nearly 20 percent. Poll results from the American Society for Radiation Oncology indicate that the reductions would entail a 30 percent payment cut for community-based practices, and two out of five survey respondents who identified themselves as community-based said they would have to shutter their practices if the CMS proposal is finalized this fall. According to the survey, nearly 50 percent of rural practices would need to close, while 60 percent of community practices with multiple locations would have to consolidate. Furthermore, 54 percent of practices would no longer accept Medicare patients, and almost 70 percent would limit the number of Medicare patients. In general, 97 percent of community practices warned that the CMS cuts would result in a decline in the quality of care for cancer patients receiving radiation therapy. The cuts would take effect on Jan. 1, 2010, and four members of the U.S. House of Representatives are urging their colleagues to sign a letter they have submitted to Health and Human Services Secretary Kathleen Sebelius asking that she intercede before the finalization of the proposed reductions. "Radiation oncology is critical for the effective treatment of our nation's cancer patients," said Rep. Lois Capps (D-Calif.). "We need to make sure that all cancer patients, including those who live in rural areas and depend on Medicare, have access to all the tools and resources they need to make a full recovery."
From "Radiation Oncologists Say Proposed Medicare Cuts Would Close Clinics, Harm Patients"
American Medical News (08/11/09) Silva, Chris
Clinical Practice
FDG-PET and CT Appear More Effective for Staging Colorectal Liver Metastases Than CT Alone
Fluorodeoxyglucose positron emission tomography (FDG PET) in combination with computed tomography (CT) is far more effective in its capability to diagnose and stage colorectal liver metastases than CT alone, according to a randomized controlled trial by Netherlands researchers published in the Journal of Nuclear Medicine. The trial involved 150 patients with colorectal liver metastases recommended for surgery, with half randomly assigned to receive CT scans only and the other half receiving CT plus 18F-FDG PET scans. The researchers followed up with patients for at least three years, with futile laparotomy being the primary outcome measure. Futile laparotomy was the outcome for 45 percent of the CT-only group, versus 28 percent of the 18F-FDG PET group; the relative risk reduction was 38 percent. This led the researchers to the conclusion that the addition of 18F-FDG PET to the work-up for surgical resection of colorectal liver metastases prevents unnecessary surgery in one out of six patients. The researchers observed, however, that their determinations were made with separate CT and PET gear, and with the emergence of PET/CT fusion technology since then, in the future "the actual reduction of futile laparotomies will be larger than 38 percent."
From "JNM: FDG-PET Better Than CT for Staging Colorectal Liver Metastases"
Health Imaging & IT (08/09/09)
MRI May Cause More Harm Than Good in Newly Diagnosed Early Breast Cancer
According to a new study, the use of magnetic resonance imaging (MRI) before surgery to assess the extent of early breast cancer has not been shown to improve surgical planning, reduce follow-up surgery, or reduce the risk of local recurrences. In order to reach this conclusion, researchers reviewed available data on a preoperative MRI's detection capability and its impact on treatment. After concluding this review, the researchers found that there is evidence that MRI changes surgical management, generally from breast conservation to more radical surgery, but that there is no evidence that it improves surgical treatment or outcomes. "Overall, there is growing evidence that MRI does not improve surgical care, and it could be argued that it has a potentially harmful effect," conclude the researchers.
From "Review of Preoperative Magnetic Resonance Imaging (MRI) in Breast Cancer"
CA Magazine (08/09) Houssami, Nehmat; Hayes, Daniel F.
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.
Abstract News © Copyright 2009 INFORMATION, INC.
Radiological Society of North America, Inc.,
820 Jorie Blvd, Oak Brook, IL 60523-2251
|
