Diagnostic Imaging's Weekly Scan: Oct. 23, 2020

October 23, 2020
Whitney J. Palmer

Ultrasound as the New Stethoscope; Pre-Operative MRI and Dense Breasts; Spectral CT and COVID-19; Corporatization in Radiology

Welcome to Diagnostic Imaging’s Weekly Scan. I’m senior editor, Whitney Palmer.

Before we get to our featured interview with Drs. Rich Heller and Nina Kottler from Radiology Partners about corporatization in radiology practices, here are the top stories of the week.

Think back for a moment to being a medical student – what one tool was always at your side. No doubt, you immediately thought of your stethoscope. Well, there’s a potential paradigm shift underway in medical education that could have point-of-care ultrasound taking over that coveted spot. Together in partnership, ultrasound manufacturer Vave Health and the College of Osteopathic Medicine at Touro University in Nevada have launched a new ultrasound curriculum that weaves image acquisition and interpretation instruction into nearly all levels of didactic training. At the same time students will be learning about anatomy and disease presentation, they will also be using hand-held ultrasound probes for visualization. In addition, students are getting a Vave EduPlus Membership that will give them access not only to ultrasound experts, but also to in-app content that can both help them prepare for medical exams and provide clinical context. The goal, according to Vave Health leaders, is to make the program available to other institutions who can then customize the curriculum to meet their program needs.

Throughout this year, there has been a lot of news emerging around pre-operative MRI and in what situations and for which women it works best. In an multi-institutional study published in Clinical Imaging, investigators determined that this scan performs best in women who have dense breasts who have undergone digital breast tomosynthesis rather than digital mammography alone. In these situations, pre-operative MRI is able to identify more overlooked malignant lesions. To make this determination, researchers conducted a retrospective study of 388 consecutive breast MRIs captured for newly diagnosed breast cancers between Oct. 1, 2013, to July 31, 2015. Based on their results, the team discovered MRI detected additional malignant lesions in 57 percent of all women with dense breasts included in their study. Specifically, pre-operative MRI identified 50 additional malignancies, more of which were in women with dense breasts who had undergone digital breast tomosynthesis. These findings are clinically important, the researchers pointed out, because 43 percent of women in the United States between the ages of 40 and 74 have dense breasts, and evidence continues to mount that they could benefit from supplemental screening.

Since the beginning of the pandemic, the American College of Radiology and other industry professional organizations have recommended against using CT to diagnose COVID-19. But, research published by a team of France this week in the American Journal of Roentgenology, showed that spectral CT with electron density imaging can make it easier for providers to assess the extent of lung lesions in patients who have early-stage disease. The team used a small group of four case studies from patients diagnosed and treated in their hospital to show that electron density imaging improves the visualization of ground-glass opacities compared to conventional CT scans. The team reconstructed the spectral CT images using the same standard soft kernel (filter B) and a similar iterative method that is used to capture conventional CT images. Then, they compared initial conventional CT images with follow-up scans. They found that all 45 ground-glass opacities identified in the four patients showed up better on the electron density imaging, and the lesion extent was much easier to determine. Overall, they said, these results show that it is possible to gather greater detail for earlier assessment of ground-glass opacities, potentially impacting treatment for COVID-19.

And, finally this week, Diagnostic Imaging spoke with Drs. Rich Heller and Nina Kottler from Radiology Partners about the growing trend of corporatization in the industry. They shared with us not only their experiences within Radiology Partners, but the impact that corporatization is having on radiology at the local level and as a specialty overall. Here’s what they had to say.

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