Diagnostic Imaging's Weekly Scan: Oct. 30, 2020

October 30, 2020
Whitney J. Palmer

Breast Cancer Screening in Indian & Pakistani Women; Fluciclovine PET for Prostate Cancer Imaging; Cardiac Ultrasound & COVID-19; and Improving Mammography Patient Experience

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

Before we get to our featured interview with Stephanie Johnston, a radiologic technologist at Solis Mammography in Texas, as well as the past president of the American Society of Radiologic Technologists about way to improve a patient’s mammography experience, here are the top stories of the week.

Our coverage of Breast Cancer Awareness month continued this week with a look at research published in the International Journal of Cancer. According to researchers at the Center for South Asian Quantitative Health and Education at Rutger’s School of Public Health, women of Indian and Pakistani descent get diagnoses of more aggressive forms of breast cancer at younger ages. South Asian women have the fastest growing breast cancer rate in the United States, so identifying culturally targeted screening and prevention methods could be beneficial. Based on a comparison of 4,900 Indian and Pakistani women with breast cancer to 482,250 non-Hispanic white women with the disease, the team found that not only are the number of cancers in the study group growing, but they are also being diagnosed at more advanced stages. There are distinct sociocultural reasons that could play a role here, the team said. These women may not get screened because they have transportation difficulties, they may lack family support, or they could avoid screening due to modesty, fear, or a belief that the cancer is a punishment for past misdeeds. These factors are particular problems for women who have low English proficiency, have lived in the United States for less than a decade, and who do not have confidence in the U.S. healthcare system. Consequently, the team said, the industry must develop strategies to reach these women and encourage them to come in for screening.

This week also saw a great deal of news about prostate cancer. During the American Society for Radiation Oncology annual meeting, investigators from the Winship Cancer Institute of Emory University shared the results of their EMPIRE-1 trial, revealing that adding the PET radiotracer fluciclovine to conventional imaging significantly benefits patients. In fact, they said fluciclovine PET is the “best available test” for imaging recurrent prostate cancer. According to their study results, they found that 75 percent of patients who used the PET molecular to guide their treatment were still disease-free three years later, creating an increased survival rate that was sustained for four years. This type of advanced imaging, the team said, helps providers better select patients for radiation therapy, as well guide radiation treatment decisions and planning. The team divided 165 men who had undergone radical prostatectomies, had abnormal PSA levels, and had CT or MRI imaging as part of their initial treatment planning into two groups – one that stuck with conventional imaging alone and one that underwent fluciclovine PET. At three years, the fluciclovine PET group has a 12-percent better cancer control rate, as well as a 24-percent improvement. Based on these results, the team recommends widely integrating it into prostate cancer treatment planning.

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And, the news is still coming about COVID-19. This week, the Journal of the American College of Cardiology published research that shows cardiac ultrasound can reveal how the virus damages the heart, potentially helping doctors identify at-risk patients and guiding future therapies. According to investigators at Icahn School of Medicine and Mt. Sinai Hospital, echocardiograms can identify different types of cardiac injury structural damage in nearly two-thirds of patients positive for the virus, and that damage can be linked to potentially fatal conditions, such as heart attack, pulmonary embolism, heart failure, and myocarditis. By examining echocardiograms from 305 adult, COVID-19-positive patients, the team discovered myocardial injury in 190 individuals – 62.6 percent of the study. These injuries were diverse – 26.3 percent had right ventricular dysfunction, 23.7 percent had regional left ventricular wall motion abnormalities, 18.4 percent had diffuse left ventricular dysfunction, 13.2 percent had grade II or III diastolic dysfunction, and 7.2 percent had pericardial effusions. Overall, the team said their findings point to the importance of cardiac ultrasound in managing COVID-19 patients and determining the courses of treatment.

And, finally this week, Diagnostic Imaging spoke Stephanie Johnston, a radiologic technologist from Solis Mammography in Texas. Johnston, who is also past president of the American Society of Radiologic Technologists, discussed the importance of focusing on the patient experience during a mammogram – whether a woman is a first-time or returning patient. She shared insights on how to maximize the encounter, including specific steps Solis has taken, and the touched on changes brought about from the COVID-19 pandemic. Here’s what she had to say.