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CT vendors end slice wars

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.

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.

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.

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?”

Business Briefs

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.

Business News

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.

This year has been a miserable one for the makers of PET/CT units, so miserable that one vendor-Hitachi Medical Systems of America-has stopped marketing its hybrid scanners. Others are struggling under the weight of a plunge in sales of some 30% compared with the same periods last year.

My physician friend "Bob" recently got fed up with his traditional family medicine practice and dropped out. He didn't quit medicine but decided to buck the rules and reimbursement schedules of third-party payers and create a boutique medical practice.

Breast MR is approaching celebrity status. A raft of expert opinions, notably from the American Cancer Society, has established MR in public and professional minds as a leading means to diagnose cancer among patients at high risk and possibly even among patients in the general population.

In the Promised Land of personalized medicine, roulette-style drug selection is a thing of the past. Eschewing delivery by trial and error, physicians prescribe drugs precisely tailored to a patient's genetic code. Imaging plays a heroic role in targeting the best therapy and monitoring response. Disease is foreseen years ahead of time, when perhaps it can be stopped in its tracks.