Dose Management

One of the biggest issues currently facing diagnostic imaging is the issue of dose management. While radiation is absolutely necessary it can unfortunately put a patient at the risk of cancer. Part of the problem lies in the fact that a blanket amount of radiation is generally considered right for patients. It hasn’t been until recently that smaller doses have been used without sacrificing the image and lowering the risk. There is still a concern that lowering dosage will be negative in the short run so a lot of physicians will go with what’s recommended.

Currently there are many scrambles and attempts to change the dosage issue because of a multitude of problems such as:

·       Legislation toward that effect.

·       Protests against too high a dosage.

·       State and federal regulations constantly changing.

·       Costs associated with using less radiation.

·       Pressure from healthcare writers.

With as many situations as the ones mentioned, it’s easy to see how this can actually be an issue. It’s refreshing to see how consultants are now stepping up to the plate with ideas for radiation management. Some of the interesting suggestions include building a good safety committee. A radiation safety committee is not an idea of having some guy or gal with a clipboard saying “ Well this needs to be changed.” A radiation safety committee is made up of experts that are licensed in respective fields and understand about the effects of radiation for the staff and patient. Short-term effects are as unpredictable as long term effects.

Some of the other points for dose management, according to consultant Neomi Mullens included:

·       Workflow understanding.

·       CT protocol review.

·       Software automation.

·       Policy procedure and risk management.

·       Communication, education, training.

·       Marketing Plan.

While all these points make a lot of sense, one concern is how financially sound this is. Often times practices and larger institutions have an enormous amount of expenses.It will be interesting to see how these points are implemented as time passes.

If you have any questions about X-Rays, Ct scans, MRI scans and other procedures, please feel free to give us a call. Our attentive staff here at Clermont Radiology is always eager to answer any questions that you may have.

Charla Hurst

General Operations Manager

Charla@ClermontRadiology.com  
352-241-6100 

www.ClermontRadiology.com  

References: http://www.auntminnie.com/index.aspx?sec=sup&sub=imc&pag=dis&ItemID=104262&wf=5567

New GPS, X RAY, Combo

When driving it’s amazing what a map can tell you. With the advent of GPS it’s amazing to hear a soft, robotic, female voice leading you around turn by turn. Things in life have a way of imitating one another. Diagnostic imaging is a lot like a road map, X-Rays have all the lines, masses and divisions necessary for physicians to see what’s wrong. With any diagnostic imaging procedure there are concerns such as radiation levels, erroneous diagnosis and so on. So how exactly can the situation change?

There is a new invention that helps guide catheters in cardiac imaging procedures and it uses less radiation. “ A description of the device states “The catheter is equipped with a special magnet and can be steered in two different directions, unlike other catheters. The system uses other magnets triangulating around the body to determine where the catheter is moving along a pre-recorded X-ray.”

This system sounds a great deal like a GPS system that will never really need updating. What’s a positive development is the fact that with this tool there could be a greater amount of accuracy with a lot less risk. While there is much to see since this was just released, it looks promising.

When this catheter moves it’s tracked and it moves forward properly. The concern of radiation is one that’s starting to disappear from the radar with the passing of time. Hopefully the concern of radiation will be a thing of the past eventually.

If you have any questions about diagnostic imaging procedures please feel free to give us a call. We here at Clermont Radiology look forward to answering any questions that you may have.

Charla Hurst

General Operations Manager

Charla@ClermontRadiology.com  
352-241-6100 

www.ClermontRadiology.com  

References: http://www.dotmed.com/news/story/21840

Radiology Demographics Today

Often times it’s interesting to see what groups are represented in medicine. Every specialty has a little of everything in terms of representation, men, women, minorities and so on. In diagnostic imaging it’s amazing to see that there is not a huge representation such as women or men. It was stated in a recent article in auntminnie.com that “Among the 20 largest medical specialties, diagnostic radiology ranks 17th in female and 20th in minority participation, even though radiology is the ninth largest medical specialty.”

In part there is a concern over minority groups not having much parity with other groups in terms of graduation or transition. Issues such as financial status and ability to get aid can often times be a problem. When dealing with the education part it was stated that “Efforts have been made to change the numbers on a variety of fronts -- for example, trying to speed up the pipeline of minority medical student graduations -- but the data have shown that these minority groups decline in representation when transitioning from medical school to diagnostic radiology residency.” What is it about radiology in particular?

Maybe a lot of students feel that radiologists are more like consultants than specialists. The feel that radiology is not a specialty is absolutely absurd since radiology deals with creating a diagnosis and helping clinicians establish a proper treatment program which will help a patient’s prognosis, especially if the condition is a complex one. Radiology, like any other specialty takes a great deal of concentration and focus.

Often times radiologists have to deal with the possibility of having to deal with a wrong diagnosis. Radiology takes a great deal of dedication and a special person willing to go through a lot of different ups and downs. Like any other specialty it can be misunderstood in some respects. The fact is that right now a lot of people may see radiology as a way to make money and not necessarily deal with patients as much.

The future will tell if women and minorities start moving toward radiology. In the end it’s not your ethnicity, gender or religious preference that will make you a good radiologist. It’s commitment, dedication, and sacrifice for a patients well being that makes a radiologist great.

If you have any questions about diagnostic imaging procedures please feel free to give us a call. We here at Clermont Radiology look forward to answering any questions you may have.

Charla Hurst

General Operations Manager

Charla@ClermontRadiology.com  
352-241-6100 

www.ClermontRadiology.com  

References: http://www.auntminnie.com/index.aspx?sec=sup&sub=res&pag=dis&ItemID=104241&wf=5564

CT Testing Properly

It’s always important to get whatever testing is necessary done. In healthcare a test may reveal a number of things. Patients may discover they are in perfect health, or they may discover that they could be victims of a complex condition. Diagnostic imaging procedures are often times the best way to not only discover conditions but also to treat them. As with anything, there is a possibility that diagnostic imaging procedures could be over used. Physicians don’t always overuse X-Rays, CT Scans, MRI Scans, but there are occasions when the scans are far from the correct form of testing.

Sometimes a test may reveal something that’s normal as an indicator that something’s wrong. Other times a test may not detect hard to discover symptoms that lead to a more serious condition. Complex conditions that are harder to spot may lead to serious problems and eventual death. Pulmonary Embolism is the kind of problem that when treated late can have a 30% to 35% mortality rate.

A pulmonary embolism is defined as a blockage in one or more arteries in the lungs. Here are some facts about pulmonary embolism:

• A pulmonary embolism is caused by blood clots traveling from other parts of the body.
• Pulmonary embolism is a complication of deep vein thrombosis.
• Pulmonary embolism can be life threatening.
• When detected and treated early, the risk of death can be greatly reduced.
• The best way to treat it is with anti clotting medication.

So it’s fair to ask what constitutes misuse, or inappropriate testing. In terms of CT scans for pulmonary angiography, there is a lot of apparent inappropriate testing conducted in the emergency room. A high number of CT’s are ordered and they often yield a negative result for pulmonary embolism. A big part of the problem is that this CT is considered to be an accurate method of testing but it does not necessarily spot pulmonary embolism. According to statistics there is only a 10% to 20% detection rate.

Part of the problem with this test is the fact that physicians want to take every avenue necessary when they suspect a hard to spot condition such as pulmonary embolism. Even after educational efforts to reduce the misuse of testing, there is still a spike in misuse. While there is a chance that this may change, chances are that there will be more problems in the years to come.

If you have any questions regarding diagnostic imaging procedures please feel free to give us a call. We here at Clermont Radiology look forward to answering any questions that you may have.

Charla Hurst

General Operations Manager

Charla@ClermontRadiology.com  
352-241-6100 

www.ClermontRadiology.com  

References: 

http://www.auntminnie.com/index.aspx?sec=sup&sub=imc&pag=dis&ItemID=104237

http://www.mayoclinic.com/health/pulmonary-embolism/DS00429

Facebook: Like if You Want to See My MRI

Sharing images is a vital part of the diagnostic imaging procedure. Radiologists and clinicians need to be able to communicate properly in order to create a proper diagnosis for the patient and in turn give the patient the proper form of treatment. A good question is, how can images be shared in a timely manner that helps all patients? In many respects it is very difficult to make sure that things are done in a quick and also accurate manner.

With tablet pc’s, cell phones, and many other new devices it’s interesting to see how things pan out. So how exactly does social media fit into the equation? Can you discuss something with TOUT? Will there be some way to tweet the findings? While none of that is known for certain one thing is, facebook may have some input here.

No, there is no app in facebook that invites your friends online to play a game called “Guess the complex condition.” There is an article that does talk about the facebook role in the equation. Herman Oosterwijk recently proposed a use for facebook in terms of sharing images “I would not reject image sharing via social media as being far-fetched, but rather take it as a valid option. Before we consider image sharing on Facebook, I want to describe image sharing use-case scenarios and then look at how we can accomplish this with different architectures. I'll also list the communication options and discuss the maturity of these solutions.”

While in the article the propositions are scenarios it does make sense when you think about it. To have private pages for sharing images may be useful. The way it was laid out is as follows:

• Point-to-point modality to viewer: A technologist can push certain studies directly from a modality, such as a CT in an emergency room, to a doctor's home for review at his or her DICOM viewer. There is a direct connection from the CT to the physician.
• PACS to viewer: A PACS could be set up to route all stat studies arriving from a modality directly to a physician's workstation. This is similar to the point-to-point modality to viewer push approach, but it offers the advantage of having a copy available at the PACS to be used as an intermediary. If there are multiple modalities that have to share images, the sending can be centralized from a single source, i.e., the PACS router. If a PACS does not support sophisticated routing using rules determined by information in the image header in order to determine what information goes where, one could use an add-on image router that can be provided by several manufacturers.
• PACS worklist: Images are sent to the PACS, and the radiologist has access to the PACS worklist using the PACS workstation. The workflow management features of the PACS can be used to indicate which studies are stat, which ones are being read, etc. This works well if a radiologist only reads from one hospital or multiple institutions that all have the same PACS. The same workflow is used whether the radiologist reads the images locally or accesses the PACS from a remote location.

There are issues such as connectivity and speed that need to be considered as well. While this is all extremely complex in practice it’s important to see if it has some sort of future to it. The fact is that social media plays a major role in most aspects of daily life. People depend on social media for marketing, keeping in touch, self expression, networking, and a host of other things.

If you have any questions about diagnostic imaging procedures please feel free to give us a call. We here at Clermont Radiology look forward to answering any questions you may have.

Charla Hurst

General Operations Manager

Charla@ClermontRadiology.com  
352-241-6100 

www.ClermontRadiology.com  

References: http://www.auntminnie.com/index.aspx?sec=sup&sub=pac&pag=dis&ItemID=104203

Unnecessary Procedures

Sometimes it’s terrible to undergo certain tests, whether or not said tests are diagnostic imaging related. When tests are performed and they are unnecessary it will put the patient through unnecessary stress. This is the kind of situation that puts a person in dangerous territory and it also may serve as an insight to either a lack of ethical employment or confidence on the part of a physician.

As a way to combat this particular situation there is a new set of lists being released by medical societies. The lists, totaling 30 in number, covers commonly ordered but sometimes unnecessary procedures. Not all procedures are necessarily dangerous procedures but still there may be some danger in them because some physicians will over-use them.

This is a campaign that’s very positive as far as procedural medicine is concerned. It’s important to know how to avoid certain procedures. This set of lists may not necessarily be well received by everyone. It was stated that “The lists address an ongoing conversation around waste and unnecessary testing in the U.S. health care system and were developed by specialty societies using current clinical evidence.”

This set of lists takes the price factor out of the equation. It doesn't matter if it’s a cheap test or an expensive test, it does matter if it’s something that’s truly necessary. When you think of the levels of radiation in a given procedure and how they affect a patient when repeated too often, you got something else altogether.

It’s important that these lists be followed for a number of reasons. In the end it is vital that the lists be followed for the well being of the patient, as intended.

If you have any questions about diagnostic imaging procedures please feel free to give us a call. We here at Clermont Radiology look forward to answering any questions you may have.

Charla Hurst

General Operations Manager

Charla@ClermontRadiology.com  
352-241-6100 

www.ClermontRadiology.com  

References: http://www.dotmed.com/news/story/21816

A Way to Help Fight Dyslexia

If your child has dyslexia he or she may not be aware of it. Sometimes it takes years before children realize that they have dyslexia. Dyslexia can have a serious and negative psychological effect on patients. As it turns out diagnostic imaging can help this particular problem before it becomes an issue. There is a possibility that MRI scanning may be able to help diagnose dyslexia before kids learn how to read.

The implications are huge, while the study that was conducted is not totally conclusive; it gives people a ray of hope that children may have a chance to avoid dyslexia. Often times dyslexia can come about at a later stage of development. It’s vital for parents to try and help their kids with this particular condition.

In an article in diagnosticimaging.com it was stated that “Researchers know that adults who have poor reading skills also have a smaller and less organized arcuate fasciculus, a bundle of fibers that links expressive and receptive language areas. However, it was not known if this was the cause of reading difficulties or if the lack of reading caused the difference.”

This kind of statement makes a good point that leads into the idea that perhaps there is a real chance that dyslexia may be diagnosed prior to learning how to read. In the study conducted at Boston Children’s Hospital it was stated that pre-readers and early readers cannot exhibit dyslexia per say, but their pre-reading skills that predict later reading abilities can be evaluated.” If there’s a way to see whether or not kids have specific issues that will cause the dyslexia, the early detection is a good way to see.

The way the study was conducted, according to the article “The children, 21 females and 19 males, were tested on their phonological skill, letter recognition, and word identification to determine reading level. They also underwent diffusion-weighted imaging where the researchers focused on the arcuate fasciculus, the inferior longitudinal fasciculus, and the superior longitudinal fasciculus.” The study went in depth in order to establish a pattern of some sort.

Dyslexia can be battled and it’s important to go ahead and give children the opportunity to beat this particular problem.

If you have any questions about diagnostic imaging procedures, please feel free to give us a call. We here at Clermont Radiology look forward to taking your call and answering any questions that you may have.

Charla Hurst

General Operations Manager

Charla@ClermontRadiology.com  
352-241-6100 

www.ClermontRadiology.com  

References:

http://www.diagnosticimaging.com/mri/mri-may-identify-dyslexia-children-learn-how-read

Dealing With a Triple Negative Breast Cancer

Breast cancer is a leading killer of women and while great steps have been taken to prevent, detect, and cure it, it is still an issue in the health care community. Diagnostic imaging plays a vital part in the detection of breast cancer and in establishing the proper treatment program for patients being affected by it. Often times it’s extremely difficult to treat breast cancer once it’s past a certain point. When breast cancer is categorized as a triple negative it’s fair to say that there will likely not be a tomorrow.

A recent article published by auntminnie.com stated that triple negative breast cancer “accounts for 10% to 20% of all breast cancers, but it causes a relatively large proportion of deaths and has a high rate of distant metastases at diagnosis.” This simply means that within the percentage of breast cancers it covers, it kills people who suffer from it. MRI and CT scans are being linked to the appearance of triple breast cancer. The link is in the fact that a specific type of enhanced MRI and CT scan can help patient prognosis.

As is the case with many complex conditions early detection plays a role in developing a positive prognosis. The difficulty lies in how the body will react to treatment given the fact that treatment is sometimes incredibly counter productive. This particular link between imaging and cancer was found after an exhaustive study was conducted over a significant period of time. It was stated that “117 invasive breast cancers in 117 patients, with an average tumor size of 3.8 cm. Volume, grade, hormone receptor, and human epidermal growth factor receptor 2 (HER2) status were available for 110 tumors (94%), while hormone receptor and HER2 status were available for 115 tumors (98%). Twenty-four lesions (20%) demonstrated the triple-negative phenotype.” In order to arrive at their conclusions, the study was conducted to a point where everything involved was factored in correctly.

What does not help the study is a limitation in population. There are multiple other factors that range from age to allergies according to the study. According to the article “The authors cited several limitations of the study, including a sample of patients mostly with advanced disease.” Therefore, the ability to generalize our results to the breast cancer population at large is limited.”  

Only the future can tell what’s going to happen with this particular development. Hopefully there will be a greater portion of early detection result treatments with the MRI and CT scans suggested by this study.

If you have any questions about diagnostic imaging procedures please feel free to give us a call. We here at Clermont Radiology look forward to answering any questions you may have. Our commitment to patient satisfaction and top quality service has never been stronger.     

Charla Hurst

General Operations Manager

Charla@ClermontRadiology.com  
352-241-6100 

www.ClermontRadiology.com  

References:

http://www.auntminnie.com/index.aspx?sec=sup&sub=mol&pag=dis&ItemID=104151&wf=5562