Facility Management

Prostate cancer imaging experts sent out a clear message in 2007: Prostate cancer in the U.S. has become an unrecognized patient care crisis that needs tackling. The good news is these experts agree that advanced imaging technologies could help in early detection and minimally invasive treatment. The lack of a cohesive national strategy is worrisome, however, and they want to see the adoption of a broad initiative for diagnosing and treating prostate cancer similar to that for breast cancer.

Diagnostic imaging centers have experienced significant ownership changes over the last few years. Radiologist affiliation arrangements, hospital joint ventures, mergers and acquisitions, as well as other creative equity sharing activities, have come to be viewed as key to capital formation strategies necessary for succeeding in the highly competitive diagnostic imaging center industry. At the core of each of these transactional activities is financial valuation.

Emory University trial results showed that a new technique called stereoscopic digital mammography reduces false positives by 49% and false negatives by 40% in women with an elevated risk of breast cancer. But the technique may have difficulty catching on, as it requires double the images and double the radiation dose compared with conventional digital mammography.

Medicare has proposed a national coverage policy for cardiac CT that would slam the door on outpatient payment for the most popular applications of cardiac CT.

An hour after the RSNA show floor opened, employees of Philips Medical Systems lifted the earth-toned drape that obscured the company’s answer to Toshiba’s flat-panel CT. The 256-slice system was as much a surprise as Toshiba’s 320-element system, as each company exceeded expectations in an industry marked this year by superlatives.

Hitachi Medical Systems America created the market for open MR almost single-handedly in the mid-1990s. This market segment, which in its heyday accounted for about 40% of new MR sales in the U.S., has all but vanished, leaving a trickle of demand.

If we were to believe vendors, radiology would be awash in breakthroughs. But, in reality, industry advances are rare, which is all the more reason to celebrate the events of RSNA 2007.

Among its final acts of 2007, Congress approved a moratorium delaying a scheduled 10.1% cut in Medicare physician reimbursement called for by the Sustainable Growth Rate formula. The cuts would have been implemented Jan. 1, 2008.

Immune to the effects of the Deficit Reduction Act and impervious to concerns of obsolescence, digital mammography this year will achieve nearly triple-digit growth in the U.S. In the first half of 2007, demand for digital mammography almost doubled with about 770 units sold to U.S. customers compared with 400 in the first half of 2006.

If we were to believe vendors, radiology would be awash in breakthroughs. But, in reality, industry advances are rare, which is all the more reason to celebrate the events of RSNA 2007.

An overwhelming majority of the audience at an RSNA special focus session voted in favor of keeping up the efforts to get FDA approval for the use of contrast ultrasound for general radiology applications.

To the medical community, teleradiology means extending high-quality medical service into underserved areas and expanding medical practice into the 21st century. To the legal community, however, teleradiology brings to the fore issues that have bedeviled healthcare lawyers for years: licensure, jurisdiction, and liability.

A 1996 National Aeronautics and Space Administration report speculated that telemammography could be used to connect neglected rural patients with timely, critical medical expertise-if only an adequate communications infrastructure in these areas could support such an undertaking. NASA went on to predict that global satellite networks then evolving could bring low-cost telecommunications infrastructure connectivity to virtually any location.

Slightly over a year and a half since the opening of the National Oncologic PET Registry, the conclusion has become clear to participants and program managers: Coping with the paperwork involved is not always easy, but it is worthwhile.

One mild day in San Francisco in late September, a few dozen people from all over the globe passed around sample rectal tubes, boxes of various bowel preparations, and other clinical paraphernalia. The props were part of a hands-on virtual colonoscopy workshop with instructor Dr. Judy Yee, an expert in the blossoming technique.

The growing cost of funding healthcare means that budgets must be managed carefully. Clinicians and radiologists are under increasing pressure from payers to economize. At the same time, many specialties face a shortage of trained healthcare professionals. This is creating room for others to step in and manage what was traditionally regarded as another professional's turf.

An overwhelming majority of the audience at an RSNA special focus session Thursday voted in favor of keeping up the efforts to get FDA approval for the use of contrast ultrasound for general radiology applications.

Merge Healthcare has become the first U.S. RIS/PACS company to enter the fast-growing teleradiology market, offering a service that gives U.S.-based radiologists consultation interpretations provided by radiologists based in India.

Multislice CT is a promising tool for autopsy, and it’s likely that scanners will eventually be installed in many of the major medical examiner’s offices around the country. Who will read these cases remains to be seen, however, according to researchers from the University of Maryland Medical Center.

An abbreviated field-of-view can lead to a 48% cut in radiation dose for CT pulmonary embolism exams and 96% dose reduction compared to full-view 64-slice CT triple rule-out without affecting the diagnostic sensitivity of either procedure.

Radiology is at a crossroads, according to three prominent radiologists who have followed the specialty’s digital revolution and evolution of practice. Their message was characterized by the RSNA as “a warning and a challenge.”

In keeping with family tradition, my niece has entered the radiology business. She is getting ready for her first RSNA meeting and asked me, “As a potential customer, what would you want to see or hear at our booth this year?”

RadNet shows 3Q growthFonar losses shrinkViztek prepares billing module for RSNA

Imaging advocates fear the adoption of a bundled approach to Medicare reimbursement for contrast media, radiopharmaceuticals, and the technical component of medical imaging could lead to substantial payment cuts from the Hospital Outpatient Prospective Payment System.

Independent diagnostic testing facilities have only until the end of the year to dissolve imaging equipment leasing arrangements with referring physicians to comply with new rules in the 2008 Medicare Physician Fee Schedule that becomes effective Jan. 1.

Although stricken by shortfalls in revenue and net during the third quarter, Alliance Imaging has entered into a definitive agreement to buy New England Health Enterprises Business Trust. NEHE’s seven imaging centers, which provide MR and CT, and its mobile MR operation will expand Alliance’s current holdings of 470 diagnostic imaging systems. Of these systems, 74 are located in hospitals or clinics.

Because modern digital detectors can be tuned to be more efficient than screen-film systems, they automatically lower the radiation dose to the patient while maintaining the image quality radiologists crave.

MR detects subtle damage in brain trauma patientsCT or x-ray based studies are typically chosen to evaluate trauma patients. But patients with brain injuries, even slight ones, may be examined more thoroughly with MR.Siemens set to acquire Dade Behring Alliance Imaging 3Q slips, bids for imaging chainIDC lands Chile contract Merge buys time to tradeAmicas revenues rise

Persuading cash-strapped hospitals to commit resources for a clinical interventional radiology service may seem a hard sell. But interventional radiologists can make a strong case by concentrating on economics, especially now that more and more hospitals in Europe will be adopting the flat-rate reimbursement system based on diagnosis-related groups (DRGs) used in the U.S.

The increasing use of multislice CT has raised questions about patients' rising radiation burden. But CT can-and should-be a low-dose modality, according to Prof. Dr. Willi Kalender, director of the Institute of Medical Physics at the University of Erlangen in Germany.