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SIIM 2021 Virtual Annual Meeting: May 24 - 27, 2021

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Image IQ Quiz: Patient Presents With Ankle Pain

Last time around, I dwelled on the so-called “pay per click” model of radiology-compensation. As then mentioned, I’ve seen some love it, some loathe it, and a lot of folks scattered across the spectrum in-between.

Most of the non-polar sentiments include a recognition of tradeoffs: Yes, it can be a bean-counting, headache-making, quarrel-inducing mess, but what else are you going to do? Just pay people a set amount and hope they’ll do a reasonable amount of work? Not noticing/caring if they seem to be pulling harder than others on the team who earn just as much, if not more?

A “happy medium” system would be one in which rads knew they could go about their work without fretting over the daily vagaries of their RVU tally…but nevertheless assured that their productivity would be on the record. And that slackers on the team wouldn’t go undetected.

Leadership would, similarly, have an idea who was shouldering how much of the group’s burden…without having to constantly tinker with complex schemes of differing exam-values, deterrence-mechanisms for “cherrypicking” of easier or higher-value cases, etc.

Tracking RVUs, or even RVU-related “work units,” doesn’t really get at this. You certainly wind up with a bunch of numbers to apply to your rads, numbers which can be put on tables and charts for periodic review. You can make sophisticated-looking curves to show a rad’s productivity over time, and stack them up against other rads, throw in standard-deviation ranges, etc.

Most rads who’ve been working more than a little while have seen their performance tracked. Even if you’re not in a pay-per-click situation, the folks in charge need to know if you’ve been generating enough revenue to warrant whatever salary or hourly rate you receive. Also how to fairly apportion bonuses and consider requests for raises.

But as long as all of that is based on curves, bar-charts, etc. derived from your RVU total, the per-click issues are a big part of the picture. Somewhat paradoxically, I think adding a 

 curve would simplify things, for groups preferring to operate via salaries or hourly rates:

By all means, keep tracking RVUs. After all, if that’s how your group is receiving its revenue, it doesn’t make sense to pretend otherwise. Rads who are doing the heavy lifting to make that revenue happen should definitely be recognized, if not rewarded.

But alongside the RVU curve, have another measurement, truer to the simplicity that “per click” implies: A curve of the raw number of exams a rad has read.

This way, the rad(s) who are dealing with the neverending onslaught of low-paying studies like XR…work that has to get done one way or another…can be tracked for the service they are providing. One important facet of which is running interference so the RVU-sluggers can focus on their MR.

Maybe the rads who would look better on the second curve don’t have the skills to read many of the higher-ticket scans. Maybe they prefer lower-tech modalities. Or maybe their other responsibilities (fluoro, diagnostic mammos, fielding phone calls, etc.) interrupt them so much, it’s just easier to squeeze “bite-sized” studies like XR in between.

If such rads know that they will be valued for taking care of the mountain of XR—despite that mountain’s reimbursement-worth being unimpressive next to a reasonable daily haul of MR and CT—they can go about their work without constantly being tempted to sift through the list for brainscans to shore up their RVU-numbers.

When it’s time for performance reviews, each rad’s two curves can then be seen as equally-important parts of the big picture. Total exams in bottom quartile, but you’re tops RVU-wise? You did your part. RVUs low, but study-volume high? You get praise, not browbeating.

Sort of like being on a track-n-field team: A sprinter is used/valued for what he can do in the 100-meter dash. A distance-runner is regarded for his performance in the 5k. You wouldn’t put either guy in the other’s event and expect good results.

Of course, rads aren’t quite as pigeonholed as all that. Some might do well if told, each day they came into work, whether they should be going for case-volume or RVUs. Or self-select which suits them at any given moment, depending on their mood or circumstances around them.

Obviously, not everybody can be focused on the same curve; the work all needs to be done. Some coordination of efforts via assignment of roles might be needed to avoid all the XR getting gobbled up early in the day, lest there be dozens of RVU-heavy scans that only a fraction of the group can take care of. Or the opposite: Nothing but XR left on the lists at 4pm, and while some of the volume-centric rads industriously plug away, the “I wish I had some MR” rads reluctantly poke through a few cases at a snail’s pace.

 of a rad’s curves are relevant, rather than just choosing one to be his personal yardstick. A top-quartile RVU-rad with bottom-quartile volume, for instance, might be considered as being on the same level as a top-volume/bottom-RVU member of the team…as well as a rad who’s dead-center for both RVU and case-number.

Meanwhile, a rad in the 75th percentile on both of his curves might be considered something of a hero, and bonused appropriately. And a rad whose two curves were in the bottom 10% might be approached for remediation…unless, of course, that rad had other roles of value such as in administration.

Because not everything shows up on curves, no matter how many you’re willing to draw.

Clicks and Curves

Michelle Alexander has over 20 years experience as a registered sonographer and greater than 10 years in the development of strain elastography, point shear wave elastography and real-time shear wave elastography. Michelle has done extensive global scientific research with all types of elastography in the areas of liver, prostate, breast, thyroid, kidney, cervical and musculoskeletal applications alongside luminaries in Europe, China, Canada and the United States. In addition, she holds a patent in the United States and Europe for elastography visualization

Breast cancer is more common than most people would like to admit. In the U.S., a woman has a 1 in 8 chance of developing breast cancer during their lifetime.

That’s why the American Cancer Society recommends annual mammograms for women beginning at age 40, and even earlier for those with more risk factors.

 But scheduling and receiving a mammogram can be anxiety provoking, especially if a woman has a family history of breast cancer. If the medical professional should discover something during the exam that warrants further examination, the next step is usually an ultrasound of the breast to help clarify what is seen on mammography and if a biopsy is needed or not. The days spent waiting for biopsy results can be terrifying, so if it can be avoided it can greatly improve a patient’s wellbeing.

Luckily advancements in image quality and advanced technologies in ultrasound devices such as shearwave imaging can help. Shearwave elastographic features provide qualitative and quantitative information that can be added to mammographic BIRADS analysis, allowing sonographers and radiologists to improve specificity of breast ultrasound mass assessment.

 These tools provide the physician with additional information, and possibly eliminate the need for a biopsy.

I’ve seen these benefits first-hand. In my experience, patients will go straight from the first ultrasound scan to a biopsy if suspicious abnormalities are detected within the breast tissue on mammography and ultrasound. In order to change the patient care cycle, giving a patient a second ultrasound prior to a biopsy may help them avoid un-needed tests. I was once performing a pre-biopsy ultrasound with a Samsung RS85 Prestige® and the device’s 2D and S-Shearwave Imaging™ feature showed that the lump was just an intramammary lymph node. This meant there was no reason to biopsy it, so it was canceled.

Another imaging tool that simplifies and enhances the screening process is a feature called S-Detect™. The semi-automated reporting feature tool analyzes selected lesions and is able to define margins clearly so the user knows a more precise distance from the nipple and depth of the lesion. This is very helpful for documentation and provides clear information on follow-up visits. There is also an ergonomic benefit. In many cases, a sonographer is reaching across the patient’s body to perform a scan. The automated nature of S-Detect reduces the time a sonographer spends on the breast scanning, which therefore reduces time spent in a very uncomfortable position, causing shoulder and arm fatigue. Lastly, it may also give those who are questioning their judgement an extra layer of confidence.

As time goes on, ultrasound manufacturers are moving beyond 2D and 3D imaging, and into the world of advanced intelligence (AI) to construct new ways to display, interpret and understand what is going on inside the human body. S-Detect is a good example of this. Breast ultrasound has become an increasingly common and crucial tool used by medical professionals to determine abnormalities faster and with more confidence. In fact, because image quality and software has advanced to where it has, practitioners have even begun using ultrasound as a first modality to avoid exposing a woman to small amounts of radiation.

When choosing an ultrasound device, medical professionals should consider not only the image quality but also the software and hardware features available in order to improve both their own experience, but, more importantly, the experience of the patient.

https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html

 Recommendations for the Early Detection of Breast Cancer 

https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html

3. Berg WA et. al; BE1 Investigators. Shear-Wave Elastography Improves the Specificity of Breast US: The BE1 Multinational Study of 939 Masses. 

. 2012 Feb;262(2). doi: 10.1148/radiol.11110640. PMID: 22282182.

Advancements in image quality and advanced technologies in ultrasound devices such as shearwave imaging can help.

The Importance of Ultrasound When Determining Suspicious Abnormalities in Breast Tissue

Early PET/CT imaging after transarterial radioembolization (TARE) for liver cancer could identify early who will respond to treatment and inform further treatment steps, a new study in France found.

The single-center retrospective study, published in 

, evaluated the utility of PET/CT using fluorodeoxyglucose (FDG) or 18F-FCH (18F-fluorocholine) to predict six-month treatment response and overall survival (OS) after TARE in patients with 

“Early posttreatment evaluation with PET/CT could help more reliably identify true nonresponders after TARE, which in turn could prompt early adapted therapeutic management,” the study authors, led by Edouard Reizine, MD, of Henri-Mondor University Hospital in Créteil, France, wrote.s

The study included 37 patients with HCC treated by TARE at Henri-Mondor University Hospital in Créteil, France, between February 2016 and August 2018. Those with portal vein tumor invasion or invasion or with unifocal or multifocal HCC not eligible for local therapies or transarterial chemoembolization (TACE) were included. Mean age was 67 and the majority (34) were men. FDG PET/CT and 18F-FCH PET/CT examinations were performed before treatment and 4 to 8 weeks after treatment.

Treatment response was assessed using modified response evaluation criteria in solid tumors (mRECIST).

“In patients with HCC treated by TARE, early posttreatment PET/CT response exhibited 100% sensitivity and 100% specificity for six-month mRECIST response, in comparison with 67% sensitivity and 100% specificity of one-month mRECIST response; early postteatment PET/CT response was also a significant independent predictor of OS (HR: 0.24, 95% CI: 0.08-0.76, 

On the PET/CT before treatment, 28 (76%) patients were FDG-positive, 15 (41%) FCH-positive 6 (16%) both FDG-positive and FCH-positive.

At one month after treatment, 12 of 28 (42.9%) FDG-positive HCCs exhibited early response by FDG PET/CT; and 7 of 15 (46.7%) FCH-positive HCCs exhibited early response by 18F-FCH PET/CT. At six months, 12 (52%) patients exhibited mRECIST response. 

“Given the high percentage of HCCs that were FDG-positive, metabolic evaluation before and after TARE could be conducted by FDG alone in the large majority of patients,” the authors wrote. “Nonetheless, performing pretreatment PET/CT with both FDG and 18F-FCH helps detect additional HCCs not identified by conventional imaging, and the combination of the two tracers achieves very high sensitivity for HCC detection. Hence, imaging using both radiotracers may maximize the number of patients with HCC who benefit from metabolic evaluation.”

Limitations of the study include that it was retrospective, included only 37 participants out of 73 patients, and participants received a range of additional treatments after TARE. The authors also noted that 18F-FCH is not readily available.

The 5-year survival rate for HCC, which is the leading cause of liver cancer deaths,

Predicting how patients will respond to treatment has been a focus of providers. One 

 found that applying a deep convolutional neural network improved the ability to determine how a patient will respond to Y90-RE therapy.

 found that more frequent ultrasound screening in patients who are at high risk for developing HCC was associated with earlier HCC detection, decreased mortality, and improved quality of life.

Patients with hepatocellular carcinoma may benefit from early PET/CT imaging after transarterial radioembolization to predict treatment response and survival, a new study found.

Early PET/CT Can Help Predict Treatment Response, Survival of Patients with Liver Cancer

Pranav Chitkara, M.D. is a Board Certified, Fellowship Trained Radiologist. Dr. Chitkara completed medical school at The University of Texas Southwestern and his radiology residency at State University of New York in Brooklyn. Dr. Chitkara also completed his fellowship in Musculoskeletal Imaging at Cleveland Clinic.

Infant with Prenatally Diagnosed Abnormality on Ultrasound

40-week-old male with a prenatally diagnosed abnormality on screening ultrasound. What is the diagnosis?

Image IQ Quiz: Infant With Prenatally Diagnosed Abnormality on Ultrasound

In men with intermediate- to high-risk prostate cancer, 68Ga- prostate-specific membrane antigen (PSMA)-11 positron emission tomography (PET) imaging may miss small pelvic nodal metastases, according to a study recently published in 

“A PSMA PET scan negative for pelvic nodal metastasis does not indicate that a pelvic nodal dissection is not required,” wrote Thomas Hope, M.D., of the University of California in San Francisco, and colleagues.

While pelvic nodal metastases detected at radical prostatectomy are associated with biochemical recurrence after 

, improved detection of metastatic disease is needed prior to definitive therapy.

This prospective phase 3 trial included 764 patients, median age 69, with intermediate- to high-risk prostate cancer considered for prostatectomy from December 2015 to December 2019. The primary end point was the sensitivity and specificity of 68Ga-PSMA-11 PET imaging for the detection of pelvic lymph nodes compared with histopathology on a per-patient basis. Each scan was read by three blinded independent readers.

Of the 764 men who underwent a 68Ga-PSMA-11 PET scan for primary staging, 277 (36%) underwent prostatectomy with lymph node dissection. Based on pathology reports, 75 of 277 men (27%) had pelvic nodal metastasis. For pelvic nodal, extra-pelvic nodal and bone metastatic disease, 68Ga-PSMA-11 PET results were positive in 40 of 277 (14%), two of 277 (1%), and seven of 277 (3%) of patients, respectively. The sensitivity and specificity for pelvic nodal metastases were 0.40 and 0.95, respectively, compared with histopathology.

“This study is the largest prospective study using PSMA PET at time of initial staging,” the authors said. The results of this study were used to support the recent U.S. Food and Drug Administration approval of 68Ga-PSMA-11 PET at initial staging.

, Joseph Osborne, M.D., Ph.D., of Weill Cornell Medicine in New York, and colleagues wrote that the results are similar to those from the prior 

 evaluating PSMA PET diagnostic performance of 18F-DCFPyL. “There is a clear message from both trials: clinicians taking care of patients with high-risk prostate cancer being assessed for prostatectomy can use a positive PET scan as a true positive,” they wrote. “Whereas a negative scan cannot be used to exclude disease or inform nodal dissection (both studies had a diagnostic sensitivity near 40%).”

Osborne and colleagues added that the latest study “has provided a road map for how preintervention PSMA PET imaging will guide the appropriateness of radical prostatectomy for the referring urologists. As such, these results are practice changing for the nuclear medicine physicians, urologists and medical oncologists who will manage this cohort of patients.”

Clinicians taking care of patients with high-risk prostate cancer being assessed for prostatectomy can use a positive PET scan as a true positive, but a negative scan cannot be used to exclude disease or inform nodal dissection. 

PET Imaging Helps Guide Patient Selection for Radical Prostatectomy  

Can you diagnose the finding seen on this panorax?

Image IQ Quiz: What Do You See On This Panorax?

A couple Thursdays ago, I got an early-morning call from my radgroup: Don’t bother trying to log in for work, that day or indeed the next few. A nasty bit of hacking had occurred, and taken their entire computer-system down.

Working via teleradiology since 2011, and in facilities large and small before that, I’m no stranger to outages. Sometimes they’re a welcome break…especially if you’re salaried and getting paid the same whether you’re working all day or twiddling your thumbs. Not as much if you know that imaging-cases are still accumulating, and you’ll be frantically trying to catch up when your access to them is restored. 

 not if you’re “per click,” earning zippity-doo-dah while your employer pulls itself together.

Unlike other outages I’d seen, this one wasn’t over in a matter of hours, or even a couple of days. I still don’t know all the details; one of the other telerads theorized that it was on the level of ransomware/cyberterrorism, such that Federal entities were involved. Everything was down, even the group’s websites and email systems, and there was nary a guesstimate as to when we’d be back on our feet.

So far beyond the realm of anything that might have been planned for, this was tantamount to a “black swan” event for the group. I’ve referenced the term in this column before, and there’s a worthwhile book on the subject (“The Black Swan: The Impact of the Highly Improbable,” by Nassim Nicholas Taleb). I won’t rehash it here.

Just because you can’t predict such things, doesn’t mean you won’t have to deal with them if they happen. And even though you can’t thoroughly plan for the unknown (or it would be prohibitively costly to protect yourself against everything that’s less than 0.001% likely to ever occur), there are some things that can make you more resilient for when it comes busting down your door.

Developing and maintaining plans for more probable/predictable incidents is a good start. Some components of those plans might be useful when a “black swan” turns up. For instance, a contingency strategy dealing with more typical, briefer outages might provide a framework for when hackers hold your system hostage or terrorists detonate an EMP in the area. It’s a lot easier to modify a partially-relevant plan for your current situation than to create one from scratch.

Even if none of the plans you’ve formulated can be adapted, devising them in the first place has you in a better place than if you hadn’t. You (and, hopefully, your team) have already gone through the exercise of thinking about the various components that make your operation work, and what happens if one or more of them are taken out. What it might take to function in their absence, if any substitutes can be used, who to call for repairs/replacements, etc. The basic process of methodically sizing up a bad situation will come a lot more readily to you if you’re done it before.

Still, by its very nature a “black swan” event isn’t tidily handled by preparation. The best means of dealing with it is being ready to take, and roll with, its punches. Rather than panicking and going to pieces, you take stock of your troubles and what’s still intact. Then, you have an idea of what stands between your current situation and normalcy, and can start figuring how to get from hither to yon.

Facets of this need not be complex puzzles or massive undertakings. For instance, my radgroup’s usual means of communication (email and instant-message app) were down. Reestablishing contact began with simple phone-calls, followed by external email accounts. Those wanting to keep personal e-ddresses out of the mix simply created new Gmails for the purpose. Group-messages could then be used to relay marching orders and share updates as new information became available (also for offsite rads like myself to post questions).

Another important aspect of being able to roll with the punches is having flexibility and redundancy in your setup. If, under even the best of circumstances, your operation is stretched to its limit or liable to unravel if one tiny component falls out of place, it won’t take a black swan to create havoc…but such an event will be all the more devastating when it happens.

More robust by far is an organization whose members’ roles overlap. If one or more are taken out of commission for any reason (illness, equipment failure, whatever), others might have to stretch in compensation but the net is more capable of holding the burden than tearing under it. And if members of the team are used to having Operations “call an audible” to redirect their efforts when circumstances warrant, they’ll be that much more capable of shifting focus in times of crisis.

Individual members of the team can also make themselves more resilient for when black swans come a-calling. In a lot of ways, similar to the organizational-level stuff: Don’t panic, be ready to adapt as situations arise, etc. That’s especially important for per-click rads who might be facing a sudden cutoff of income for the duration of an outage. Having emergency funds in reserve, for instance, instead of living paycheck-to-paycheck. Some might even maintain separate sources of income, such as contacts with locums agencies.

Simply keeping an adaptive frame of mind can go a long way: Sure, it might be worrisome when your employer is down for the count and you don’t know when they’ll be back up. Maybe you nervously eyeball job-listings, just in case…but, in the meantime, you’ve suddenly got an unexpected bit of vacation. Even if it’s unpaid, try to make use and/or enjoyment of it. Sleep in, jumpstart your fitness regimen, get that stuff done around the house you’ve been putting off, meet up with some friends you haven’t seen.

That visit from the black swan, played the right way, might ultimately turn out to be something you look back on and realize you desperately needed.

Even though you can’t thoroughly plan for the unknown, there are some things that can make you more resilient for when it comes busting down your door.

Things Unforeseen

Dr. Gruen is the chief medical officer of IBM Watson Health Imaging.

If only we were as good at prevention and early detection as we are at treating complex disease in U.S. healthcare. Generally, people know what they should do, and in some cases, they do it. For example, many patients religiously go to the dentist for a cleaning every six months to prevent cavities. 

But screening women with consistent mammograms beginning at age 40 to detect breast cancer?

 Not so much. Just imagine how many lives we could save if we looked for breast cancer with the rigor and diligence with which we prevent tooth decay.

An Ounce of Prevention: Weighing Evidence and Personal Risk Factors

Unfortunately, when it comes to breast cancer screening recommendations,

 there are multiple sets of guidelines, many of them different. Conflicting recommendations can breed confusion and, far worse, can potentially threaten lives. One study estimated that if women followed less stringent recommendations and started screening at age 50 (instead of 40), and women aged 50-74 only screened every other year (instead of annually), it could result in about 6,500 more deaths from breast cancer every year in the United States.

To further complicate matters, even the best evidence-based guidelines may not be the best approach for every patient. All patients need to make sure their complete history is part of their healthcare decision making, and that is particularly important for breast cancer patients. Each woman has a unique personal and family history which may impact her risk of getting breast cancer. There are many factors that women and their physicians should consider when determining the best approach to breast cancer screening, such as personal health history, family history, genetic profile and hormonal considerations, among many others.

Doctors don’t know their patients as well as patients know themselves. For example, who in the family has had cancer, especially breast, ovarian or cancer of the gastrointestinal tract? Has the patient ever had a breast biopsy that showed abnormal cells, or prior cancer? At what age did she have her first period? Go through menopause? How many pregnancies? How dense is the patient’s breast tissue? Women and their doctors must work through these issues together to pursue more effective prevention.

Where Artificial Intelligence (AI) Can Help With Breast Cancer Prevention Efforts

As a breast radiologist, I believe one of the keys to better outcomes will be a more personalized level of risk assessment for every patient. AI can help deliver this personalization. For example, women with the densest breast tissue have a higher risk of breast cancer.

 These women may benefit from more extensive screenings, such as ultrasound or breast MRI. AI can help conduct density assessments to identify higher-risk patients.

In addition to density assessment, AI can enhance breast cancer detection by helping clinicians identify abnormalities on a mammogram, including a 3D (tomosynthesis) mammogram, that might be overlooked by even the most experienced radiologist. 

There is some promising research around applying data and AI to identifying breast cancer. An IBM research team analyzed de-identified mammography images, linked to comprehensive clinical data and biomarkers, to create a new algorithm designed to predict breast cancer.

 The combined machine- and deep-learning model correctly predicted the development of breast cancer in 87 percent of the cases it analyzed – an accuracy comparable to radiologists.

There are many exciting possibilities that could result from this type of research. For example, this may be the first study to incorporate both mammograms and electronic health record data for the prediction of breast cancer, which shows the potential of one day harnessing multiple data sets and AI algorithms to tailor risk assessment to each patient. The research team 

 analyzing clinical risk elements to better understand their relationship to an individual’s personalized risk.

To be clear, AI will never replace the radiologist. Another large-scale IBM Research study found that no single AI algorithm could outperform radiologists, but the combination of AI with radiologist assessment improved overall accuracy.

And no matter how good the technology gets, there will never be a replacement for good, patient-centered care. I encourage women to know their risk and talk to their doctors about breast cancer screenings. I’d like to see all patients do for the rest of our bodies what we so willingly do to prevent dental disease. The benefits to our lives can be dramatic.

This article does not provide medical advice. For information on the benefits of breast cancer screening starting at age 40, visit the 

For a more detailed discussion of differences between recommendations, see 

“Clearing up confusion over breast cancer screening recommendations”

Hendrick and Helvie, “United States Preventive Services Task Force Screening Mammography Recommendations: Science Ignored.” 

 2011;196: W112-W116. 10.2214/AJR.10.5609

Source: NIH National Cancer Institute. https://www.cancer.gov/types/breast/breast-changes/dense-breasts

Akselrod-Ballin A, Chorev M, Shoshan Y, et al. Predicting breast cancer by applying deep learning to linked health records and mammograms. 

Schaffter T, Buist DSM, Lee CI, et al. Evaluation of combined artificial intelligence and radiologist assessment to interpret screening mammograms. 

Artificial intelligence can help seek out and identify high-risk patients who might benefit from more extensive screening. 

Personalizing Breast Cancer Risk Assessment 

There’s a new epidemic out there and it’s a pesky problem on every professional athletic field, court and course: Sports injuries.

After months of relative inactivity during the COVID-19 pandemic, professional athletes are finding their bodies are being tested more than before. With gyms and even parks closed for everyone, resuming competitive sports after a lockdown is taking an unexpected toll on pro athletes—with sports injuries on the rise in virtually every league.

Consider America’s favorite pastime, baseball. Recently, while fans were singing “take me out to the ballgame,” athletes were literally being taken out of the ballgame! 

 from Major League Baseball found that in the abbreviated 2020 season, the overall injury incidence rate per 1000 athlete-exposures was almost twice the rate compared with the two seasons—2018 and 2019—before COVID-19.

Professional football didn’t fare much better. According to a 

 the rate of injury in NFL players during weeks 1-4 of the 2020-2021 regular seasons was significantly higher than during three recent past NFL preseasons and regular seasons.

And, for the 2020-2021 season, professional hoops may as well have been known as professional hurts. Numerous NBA stars have missed playoff games this past spring with a variety of impeding injuries. There were 

 lost to soft-tissue injuries, according to certified athletic trainer Jeff Stotts, who maintains the most authoritative public injury-tracking database that covers the NBA. It's the second-highest figure recorded since tracking began in 2005-06.

Simply put, COVID-19 lockdown has wreaked havoc on professional athletes. It’s a problem of athletes doing too much, too soon. Unlike an extended “off season” when pros continue to work out and train, the pandemic lockdown limited training—or nixed it altogether. 

Now that athletes are back on the playing fields, we are witnessing the fallout. But thankfully, when injuries do happen, professional teams have a way to quickly diagnose, treat and manage them. It all starts with the right diagnostic imaging.

From coaches to catcher’s mitts, every professional team understands the value of choosing the best personnel and equipment. It all plays a fundamental role in building a winning team. 

That same philosophy extends to how pro leagues take care of their athletes. While they may not be on the field, radiologists and X-ray techs have long been an essential part of a sports team’s medical team. Now, with the uptick in injuries due to COVID lockdown and lack of practice, medical teams have become more critical than ever. 

What’s more, imaging equipment really matters—it’s truly a team’s first line of defense in getting immediate and accurate diagnoses of injuries. 

The right technology can help diagnose an athlete quickly and get the right treatment promptly started. Most professional sports teams have traditional full size mobile imaging systems at their training facilities as well as at the stadium for ready access to X-rays on demand in the locker room.

In recent years, access to imaging has become even more convenient for teams. Today, new innovations in digital radiography (DR) allow the X-ray professionals associated with a team to take the equipment even more places— reaching injured players on the field. 

It’s all because today’s portables are smaller, lighter weight and have longer lasting battery power. For example, 

 a mini-sized portable with an unprecedented 12-hour battery life. Its compact size, lightweight and versatility make it a great option for remote uses. Add to that the fact that it is affordably priced, so a team can have multiple units if needed. Its image quality is excellent for an ultra-low powered, low dose system due to the combination of Fujifilm’s high sensitivity detectors and advanced image processing. 

For higher demands, power and budgets, the more common choice is the full size 

 which provides x-ray room image quality for every possible view and every size player, with 4 hour battery power.

The benefits of portable DR are many. For example, the injured athlete need not be moved because the equipment comes to them—helping prevent added pain and possible complications from being moved prior to understanding the scope of the injury. Moreover, the ability to obtain high quality images on-site during game time means a speedier diagnosis so the best possible treatment plan can begin immediately.

Presently, Fujifilm works with professional sports teams that use FDR Go PLUS mobile systems along with 

 detectors to provide immediate diagnostic images on injuries. 

Because of the lack of a gradual return to sports, less practice before the season, and overzealous practice schedules, teams are encountering more and more injuries.

Some of the common injuries athletes are experiencing at this time include sprains, fracture, dislocations, shin splints, ACL tears, groin pulls, hamstring strains, and knee, shoulder and elbow injuries.

Figuring out the precise nature of the injury begins with diagnostic imaging. Simply put, portable but powerful DR equipment on the field, court and course is making a decisive impact in the rapid assessment of a wide variety of professional sports injuries. 

Hopefully, we’ve all learned a lot from the COVID-19 pandemic, medically and otherwise. It has shined a spotlight on so much—and sports medicine is yet another area illuminated by this pandemic. Clearly, the isolation and inability to train and practice has led to greater numbers of sports injuries. 

Now more than ever, there is a real need for professional teams to include the latest advances in portable DR as critical gear for their medical staff in treating player’s injuries on the field and the court.

NFL season is starting now and NBA in October. In the NBA, the 

 of players sidelined per game due to injury, non-COVID-19 illness or the need for rest this last season was 5.1—the highest since the 2009-2010. NFL injuries 

 over the first half of the 2020 season. In tennis, we have just seen several players drop out of Wimbledon 2021 due to everything from ankle to abdominal injuries, and this past July, a number of Olympians saw their dreams dashed due to injuries that arose after being sidelined from practice during COVID-19. 

State-of-the-art portable imaging equipment is the first line of defense to address this new epidemic of sports injuries. The sooner injuries are diagnosed, the sooner effective treatment can begin and to help speed recovery. That’s a winning game plan for every team. 

The COVID-19 lockdown wreaked havoc on professional athletes, and now we are witnessing the fallout. But thankfully, when injuries do happen, professional teams have a way to quickly diagnose, treat and manage them. It all starts with the right diagnostic imaging.

Things Unforeseen

Personalizing Breast Cancer Risk Assessment

Portable Digital Radiography: Tackling Today’s Sports Injury Epidemic