Facility Management

E-Z-EM revels in ACRIN resultsAquarius to strut at RSNA 2007Fonar revenues rise, losses fallMerge rallies usersVarian recruits Stanford oncologist

The topic of radiation dose reduction in CT scanning has produced an abundant literature. One practitioner alone, Dr. Manudeep K. Kalra, head of the Massachusetts General Hospital's CT dose protocol optimization program, has published about 50 papers on the topic.

The extra radiation inherent in new CT technologies has made more urgent the need for strategies to reduce exposure. Two recently published studies address the issue of dose reduction with the latest generation of 64-slice and dual-source scanners.

Medicare has very specific rules regarding how the supervision of diagnostic tests must be performed. To be eligible for payment, testing services in physician offices, independent diagnostic testing facilities, or provider-based entities must comply with the proper level of supervision. An overview of these rules includes the specifics for supervising and billing for services performed using physician extenders.

Small-field-of-view positron imaging, optimized for breast cancer detection, is jockeying for position among several adjuncts to x-ray mammography. A proponent of the technology, Dr. Kathy Schilling, believes it has an edge over MRI.

Questions remain from practitioners, payers, and administrators regarding the economic impact of coronary CT angiography on established diagnostic modalities and the effects on reimbursement within imaging. To address these concerns, we have developed the CCTA Data Registry, which now consists of more than 20,000 cases. Preliminary results indicate that coronary CTA is being utilized appropriately and affects savings for the healthcare system.

Breast ultrasound significantly increases detection of cancers in high-risk women but takes a big toll on the rate of benign biopsies, according to the initial results of a screening trial sponsored by the American College of Radiology Imaging Network and the Avon Foundation.

I read Greg Freiherr's column "Why the NEJM study on CAD is wrong" on your website. Please always keep in mind the following about computer-aided detection:

Efforts by researchers and radiation safety advocates in the U.S. and abroad have led to the development of several techniques and strategies to reduce radiation dose from CT scanning.

Tens of millions of people eligible for colon cancer screening every year shy away from stool tests and the invasive colonoscopy exam. They could soon have another viable option: CT colonography.

Opposition to the Deficit Reduction Act cap on imaging reimbursements has inspired a grassroots coalition to conduct a political campaign in New York State uniting radiologists and patients against the Medicare rate cuts and other federal initiatives against medical imaging.

If the Deficit Reduction Act of 2005 wasn’t enough of a blow to the imaging industry this year, just wait. Congress has a surprise awaiting us in 2008.

Executives from GE Healthcare, Siemens Medical Solutions, and other imaging equipment vendors visited the White House last week to meet with presidential advisors about the effect of declining Medicare payments on the medical imaging industry.

The coming merger of Philips’ medical systems and home-care healthcare under its Vision 2010 initiative, announced Sept. 10, will allow cost savings through streamlined operations and increased revenues achieved by taking market share from competitors, according to Steve Rusckowski, the newly ordained leader of this soon-to-be-minted business unit.

As recently as last summer, industry pundits were predicting 10% growth in PET/CT sales, driven partly by expectations that the number of annual procedures would continue to grow by 20%. Then came the Deficit Reduction Act (DRA), and rulings by the Centers for Medicare and Medicaid Services that cut reimbursement in half for outpatient imaging centers.

The American College of Radiology has asked members for feedback on a draft of clinical performance measures involving several radiology subspecialty areas. The measures, designed to improve the quality of medical services, may be used to support pay-for-performance plans sponsored by the Centers for Medicare and Medicaid Services.

A battle to stop federal lawmakers from further restricting reimbursements for medical imaging is shaping up on Capitol Hill. The battleground is a provision built into the Children’s Health and Medicare Protection (CHAMP) Act of 2007.

Bob Bell has advice for the scores of freestanding MRI services that suddenly faced a possible loss of privately insured business when United Healthcare announced that it would limit reimbursement to sites that are accredited or seeking accreditation on March 1, 2008.

In the face of the changing dynamics of the PET/CT market, Hitachi Medical Systems America has decided to stop promoting its SceptreP3 product line.

A study by researchers from Boston and Brussels has found MR imaging more accurate than bone scintigraphy and x-rays for detection of bone metastases from prostate cancer. MRI could boost staging and management of these patients in a cost-effective way.

Free-standing imaging facilities have taken some hits lately. This is no secret to readers of Diagnostic Imaging, but they've not always been under such intense fire.

Imaging centers across the U.S. have cut back drastically on their purchase of big ticket products. Demand for 64-slice CTs and PET/CTs has plummeted in the wake of belt-tightening prompted by the Deficit Reduction Act. MR sales are sliding, as are those for ultrasound. RIS/PACS, however, is gaining ground, and much of its gain is coming in the outpatient arena.

The need for nighttime coverage relief was the initial driver of commercially viable teleradiology. For several years, however, the local in-house radiology group gained no economic value for outsourcing its nighttime work, because its members had to reread the cases the next day to formally convert the reports to primary reads. The group also had to pay a premium for nighttime services.

Vendors have employed a multitude of approaches to cut patient radiation dose by making data acquisition and analysis more efficient. Software has been developed to adjust dose to fit different body types and segments. Methods to factor in body weight, particularly when scanning children, have been considered. Step-and-shoot protocols have been devised to eliminate the overlap that comes from spiral scanning.

FDG-PET performed after two cycles of standard chemotherapy can accurately predict which patients with Hodgkin’s lymphoma will respond or relapse, according to a multicenter international study published in the Aug. 20 issue of the Journal of Clinical Oncology.