Diagnostic Imaging Weekly Scan: Oct. 9, 2020

October 9, 2020

Dual-Energy CT's Impact in the Emergency Department; Mass Casualty Planning; Language Barriers to Mammography for Spanish-Only Speakers; Improving the Patient Experience for Mammography During the Pandemic

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

Before we get to our featured interview with Dr. Stamatia Destounis about patient experience with mammography during the pandemic and how radiologists can improve those encounters – here are the top stories of the week.

Radiologists in the emergency department have a tool at their disposal that can help not only boost their confidence in their interpretations, but it can also reduce the number of unnecessary exams and provide substantial cost savings. In a study published in American Journal of Roentgenology, a team from Vancouver General Hospital shared their experiences with dual-energy CT. To uncover the impact the modality can have, the team examined all dual-energy CT scans – 3, 159 cases – performed in their emergency department between Jan. 1, 2016., to Dec. 31, 2016. These studies fell into five categories: head and neck, chest, abdomen and pelvis, spine, and musculoskeletal. They found dual-energy CT changed management in 298 cases, increased diagnostic confidence in 455 studies, offered additional relevant information in 174 cases, and helped characterize incidental findings in 44 instances. Using dual-energy CT – compared to using CT alone – also helped patients avoid a significant number of unneeded studies – between 162-to-191 MRI exams, 21-to-28 CT exams, and 2-to-25 ultrasounds. And, the impact also extended to the bottom line – among the lowest-cost studies, using dual-energy CT saved $52,991.53, and the savings were even greater among the most expensive exams -- $61,598.44.

The American Society of Emergency Radiology also wrapped up their 2020 virtual annual meeting this week, providing a significant amount of information about how radiology can – and should – be used in critical, time-sensitive situations. In particular, Dr. Susan Cross from Barts Health NHS Trust outlined what emergency radiologists can do to plan for mass casualty events. While it can be difficult to plan for events that may never happen, she said, it is important for emergency radiologists to reach out to non-imaging colleagues to create a plan for when these types of situations occur. It’s important to remember that there will be a significant role for whole-body CT during these emergencies, but due to the sheer volume of cases coming into a single institution, it is possible, she said, that many patients will be shifted to minimally acceptable care for initial analysis, such as plain films. Ultimately, she said, after you create your plan, drill, practice, and conduct table-top sessions to prepare as much as possible – and, if you have a mass casualty event, be sure to de-brief afterwards so you can identify any places where you can improve.

Investigators at the American College of Surgeons Clinical Congress 2020 shared research that shows women who only speak Spanish are at greater risk for not getting the screening mammograms they need. According to general surgery researchers from the University of Illinois at Chicago, Spanish-only speakers appear to have a 27-percent less likelihood of having a screening mammogram than women who speak English. They based their work on women above age 40 who live in the United States. Existing screening guidelines are already confusing because there is no one recommendation on when a woman should begin annual exams, and a language barrier only makes it harder for women to access these services. To determine the impact of language, the team reviewed health records from 1,040 women who had limited English proficiency. According to their analysis, the overall screening mammogram rate was 12 percent less for women in this group compared to those who spoke English proficiently – 78 percent to 90 percent, respectively. This rate was consistent across age groups. Of the group, 209 women reported never having had a screening mammogram. The team extrapolated that information for the entire U.S. female population between ages 40 and 75 and discovered that equals an estimated 450,000 women nationwide who are eligible for, but have not had, a screening mammogram.

And, finally, this week, Diagnostic Imaging spoke with Dr. Stamatia Destounis, a breast imaging radiologist with Elizabeth Wende Breast Care in Rochester, NY, about the important factors that affect the patient experience with mammography, as well as the impact the pandemic has had on the ability of imaging centers to make these encounters as comfortable and calm as possible. In addition, Dr. Destounis offered tips for how imaging centers can augment what they are already doing to maximize the mammography experience for women who might find the exam uncomfortable or frightening. Here’s what she had to say.

For more coverage based on industry expert insights and research, subscribe to the Diagnostic Imaging e-newsletter here.