Facility Management

It's been a year since practice manager Lorna Vaughan took out an ad seeking a breast imager to work on the Jersey Shore. To her surprise, a "dream-come-true, fee-for-service, patient- focused, personal and compassionate practice with partnership and ownership opportunity" has been a hard sell.

Radiology PACS and cardiology PACS have more in common than the same last name. Similarities include diagnostic workstations, archive infrastructure, DICOM modality work list functionality, web-based distribution, and interfaces to hospital information systems and electronic medical records.

The largest multi-institutional study to date examining the effect of PET on the management of recurrent colorectal cancer has found that its finding led to change in the treatment plans for more than half of patients.

An unscheduled shutdown of the High Flux Reactor at Petten in the Netherlands has raised concern about a possible interruption of molybdenum-99 supplies for nuclear medicine procedures in Europe and North America.

Draft of global standards covers image quality, security, and controversial issues such as liability In what is likely a precursor to uniform standards for clinical teleradiology, an international network of radiology organizations has drafted guidelines for the burgeoning teleradiology industry.

A Centers for Medicare and Medicaid Services advisory panel has found that most available clinical data for nine conditionally approved cancer indications of FDG-PET, evaluated by the National Oncologic PET Registry and a separate Canadian study, are too ambivalent to support Medicare coverage.

Telemedicine has developed considerably over the past four or five years, turning from a much-debated theory into a practical reality. E-prescribing, telemonitoring, and teleradiology are becoming increasingly commonplace, and further growth in these and other areas is likely.

The nationwide shortage of radiologists, coupled with the growing acceptance and prevalence of teleradiology, has many radiologists and group practice managers seeing opportunities in places they previously would not consider.

The International Society for Magnetic Resonance in Medicine is geared toward the eggheads of MR: the knob twisters who squeeze as much from their clinical scanners as they can, the experimentalists who push the limits of ultrahigh-field imaging.

Just in time for a looming onset of new liver disease, MR elastography has arrived to employ principles as old as palpation and as new as cross-sectional imaging to create an accurate, noninvasive way to diagnose and stage hepatic fibrosis and other liver disorders.

Pro-radiology forces are claiming mandated Medicare accreditation as a victory. They will have to wait until January 2012, however, to see the actual implementation of federal law passed in July to mandate accreditation for high-tech medical imaging covered by outpatient Medicare.

Bexxar and Zevalin have become the poster children of inadequate reimbursement for radiopharmaceuticals. Despite recent Congressional action to freeze their payment rates until January 2010, advocates for these radioimmunotherapic agents say more should be done to support the application of these clinically valuable but extremely expensive drugs.

Epix CEO quitsAmicas customer upgradesRadNet acquires Delaware centerStereotaxis expands Biosense dealVarian appoints new government liaison

Siemens showcases ultrasound for triageNuc med gains on White House loss

A showdown between President Bush and Congress over Medicare physician payments concluded Tuesday when the House and Senate overrode the president’s veto of HR 6331. The aftermath brings relief to physicians until 2009 and could have significant long-term implications for radiologists and imaging practice.

White House officials urged Republican senators Friday to reverse their support of a Senate bill that would set aside an impending 10.6% physician payment cut from Medicare, allowing President Bush to veto the legislation.

The Senate passed key legislation July 9 that forestalls a 10.6% cut in Medicare physician payments following intense lobbying from patient and physician advocacy groups over the Independence Day Congressional recess. The 69-30 tally in favor of the bill makes it veto-proof.

Pending clinical trial results played a pivotal role in the Centers for Medicare and Medicaid Services' decision in March to set aside plans to establish a national payment policy for outpatient multislice coronary CT angiography. Other published trials advanced our understanding of how nuclear cardiology, echocardiography, and cardiac MRI fit in evolving diagnostic practice.

Now that computer-aided detection has become part of routine clinical work for cancer screening in mammograms and is being applied in the differential diagnosis of cancer in the lung and colon, it's only a matter of time before it rates as the standard of care for diagnostic examinations in daily clinical work.

Showing CT colonography's value for cancer screening was one thing. Proving it could handle the volume of patients who may need the test in years to come, however, is an entirely different task. Researchers say not to fret.

A system presented at the SIIM meeting is able to develop work lists based on a patient's insurance and a radiologist's credentialing status, which are important considerations as more studies are interpreted away from central offices and facilities try to maximize reimbursement.

Screening ultrasound paired with mammography improved breast cancer detection in high-risk women, but the combination also caused a spike in the number of false positives, according to an update to the American College of Radiology Imaging Network 6666 trial. These results may render ultrasound less attractive than MRI in this patient population.

The patient who reported for a CT scan at the Spring Valley imaging center in Las Vegas complained of headaches, but the images returned by the newly installed AquilionOne CT scanner indicated something much worse was probably on the way. Neuroradiologist Dr. William Orrison defined a major region of hypoperfusion in the brain, a warning sign that the patient was at risk of stroke.

The first six months of 2008 demonstrated the connectivity of diagnostic imaging.

Several radiology-related professional societies have joined forces to urge the Centers for Medicare and Medicaid Services to approve national Medicare coverage for CT colonography to screen patients for colorectal cancer.

Society of Nuclear Medicine officials say the Centers for Medicare and Medicaid Services is manipulating the definition of radiopharmaceuticals to artificially deflate its payment rates for radioactive imaging agents essential to nuclear and molecular imaging practice.

The launch of the experimental Japanese WINDS satellite in late February holds promise for teleradiology, with researchers hoping the geostationary Ka-band communications satellite will boost teleradiology into a new ultrahigh-speed communications era.

The U.S. Senate fell six votes short Thursday, June 12, of achieving the 60 votes needed to block debate on legislation that would have set aside an impending 10.6% cut in Medicare physician payments.

Interventional radiologists, like their diagnostic counterparts, remain under pressure as payers ratchet back reimbursements. But they continue to fight on the reimbursement front and see some silver linings in new government programs designed to improve the quality of care.

Contrast-enhanced ultrasound for abdominal applications in radiology was first approved in Canada in 2001. Although reimbursement issues have prevented its general dissemination and adoption, ample publications describe the benefits and applications of this exciting and robust technique.