Facility Management

Pressure to go filmless has been mounting for years. Rising chemical costs and reimbursement cuts under the Deficit Reduction Act have compounded the pressure on outpatient centers such as ours to rein in escalating expenses. To make a serious dent in

A study appearing in today’s issue of The New England Journal of Medicine reports that computer-aided interpretation of mammograms is less accurate than interpretation without a computer’s help. Researchers concluded that computer-aided detection software designed to improve mammogram interpretation may actually make it worse.

The feasibility of 3T MR as a general-purpose clinical imaging modality is an ongoing controversy. Although whole-body 3T MRI has been available for several years, most systems to date have been sold to university hospitals and research facilities.

Local Medicare carriers in all 50 states have published guidelines for outpatient coverage of coronary CT angiography. Despite a model local coverage determination developed with the help of radiology societies and organizations, local payers have opted to craft their coverage rules in a way that has resulted in widely varying technology requirements and indications.

The specter of lung cancer hangs over a generation who grew up in homes where ashtrays were as common as shag carpeting. Those youngsters, now entering their 50s and 60s, may have smoked and may have quit, but the risk of cancer remains.

When imaging centers first entered the market, they provided MRI and other imaging services to patients who were referred by local physicians. These physicians selected imaging centers based on quality and convenience for their patients.

With popular actresses Sally Field and Andie MacDowell looking on, Dr. Etta Pisano picked up a Ladies Home Journal Health Breakthrough award last year, in recognition of her work in promoting better screening for breast cancer.

Patchy insurance reimbursement for breast MRI screening in high-risk women could become a thing of the past now that the American Cancer Society is backing MRI for routine use in select patient groups. In addition, results of an American College of Radiology Imaging Network trial just released support the use of MRI in breast cancer treatment planning.

The Deficit Reduction Act may have a short-term impact on purchases by imaging centers, but tightening reimbursements may, over the long haul, be promising for technologies that improve productivity. Merge Healthcare’s president and CEO Ken Rardin is banking on it, as the company prepares for next month’s rollout of Fusion MX, the latest version of its PACS/RIS, followed by a marketing blitz aimed at convincing prospects that PACS/RIS is the way to go.

The American College of Radiology has announced the opening of its own contract research organization. The ACR Image Metrix will offer imaging research services to companies that seek FDA approval for drugs and medical devices but prefer to outsource their research operations to cut costs.

Two months ago, a seasoned vendor told me that he hadn’t sold a single piece of equipment in six months. He had built his business serving entrepreneurs within the medical imaging marketplace. As a long-time friend, I could tell he was frustrated and at the same time, scared of the unknown.

Diagnostic ultrasound is ideal for many patients. No other imaging option gives them a real-time look at their own anatomy or so openly encourages discussion with the radiologist about their symptoms and the evidence of disease on the monitor.

We continue to be both amazed and intrigued by the hype showered on cardiac CT angiography and the corresponding lack of hype given to peripheral vascular CTA. No doubt, 64-slice cardiac or coronary CTA is potentially a revolutionizing technology, but PV-CTA has already revolutionized the comprehensive diagnosis and treatment of peripheral vascular disease.

This spring, the first sites in the world will begin using Philips Medical Systems' newly minted BrightView family of gamma cameras. The compact dual-head product, unveiled at the 2006 RSNA meeting, shines at the high end of the company's nuclear medicine portfolio in performance and versatility.

Nonacademic private practice groups performing cardiovascular imaging studies have flourished during the past 30 years. As more practitioners entered private practice to meet growing demand and more hospitals developed advanced heart programs, cardiovascular services became increasingly accessible across the U.S.

Outpatient medical imaging advocates fired two salvos Feb. 28 to encourage Congress to adopt a two-year moratorium against recent Medicare payment rate reductions they say cut reimbursement by half for some CT and MRI procedures.

Historically, hope has been scant for catching any chronic occlusive pulmonary disease, including asthma and emphysema, early enough to treat and reverse, or at least stabilize, the condition.

Pacific Coast Ultrasound of Los Alamitos, CA, operates at the nexus between medical need and self-indulgence, specializing in prenatal diagnostics and medically supervised 3D/4D prenatal elective ultrasounds. Throughout February, the center, which positions itself as a certified independent diagnostic facility, promotes a month-long tribute to Valentine’s Day.

For the better part of a year, imaging industry analysts have been studying and hypothesizing about the impact of the Deficit Reduction Act. I considered myself an optimist throughout most of last year, believing that an idea this bad would not make it into practice, at least not in 2007.

Expanded coverage for PET drove demand for procedures in 2006, helping push unit sales, which also benefited from local pressures on providers to keep up with the competition. Demand for upgrading the installed base to PET/CT from dedicated PET could bolster sales in the near term, just as the popularity of the modality continues to rise.

The shortage of radiologists, coupled with an increase in imaging studies ordered per patient and improved technology, has assured the meteoric rise of teleradiology. It is clearly a burgeoning field in the healthcare delivery system.

Researchers in Germany have found that low-dose 64-slice CT colonography accurately detects colorectal polyps in a screening population and tested a new visualization tool that streamlines interpretation. They released their studies at the 2006 RSNA meeting.

Millions of dollars may have been spent on the latest CT, PET, MRI, or other digital modality in your imaging center. The purchase of a PACS, RIS, or electronic medical records system may have been made, too.

The dramatic rise of informatics in healthcare in the past decade has benefited radiology perhaps more than any other medical specialty. The digitization of image creation, storage, and retrieval has nudged radiology even closer to the core of medical practice.

Over the years, we've had the privilege of checking the vital signs of many imaging modalities. Diagnostic Imaging served as a witness to the rise and fall of digital subtraction angiography and reported the PET crisis of the mid-1990s.

As the Super Bowl and college basketball’s March Madness draw near, bookies in Las Vegas are narrowing their picks and setting the odds. They have a matrix for choosing winners and losers. Season records, players, injuries, home team advantage, time off between games, and even expected weather conditions all play a part in their picks.

Capping two years of development, Naviscan PET Systems of San Diego launched at the 2006 RSNA meeting a second generation of its PET product line, PEM Flex Solo II. The compact high-resolution scanner is optimized to assess breast lesions metabolically, although it could image other small body parts.

When their hospital clients number in the hundreds, big teleradiology firms have to be efficient. Now two companies are making the same technologies and services that made them successful available to small fry. At the 2006 RSNA meeting, NightHawk and Virtual Radiologic unveiled plans to make productivity tools and resources developed for in-house use available to clients.

Those acquainted with Dr. Marc S. Levine could sum up his curriculum vitae with an inspiring statement: "unsung hero of double-contrast barium radiography." Affable and witty, Levine has led the gastrointestinal imaging section at the University of Pennsylvania Hospital since 1998 and topped last year by winning the Eminent Scientist of the Year Award from the International Research Promotion Council for helping to improve medicine in developing countries.

Radiology practices face serious challenges to their financial health. Reimbursement is under almost continuous attack, with the latest salvo arising from the Deficit Reduction Act and threats of worse to come in the near future.