Radiology professionals: Here’s your image challenge!

The new contest starts today… what is it?

The object is to guess what’s in this image. We have chosen it deliberately to be difficult for you to figure out—we had three clever individuals who correctly identified the image last month. This time we hope to stump you all! The image was made with a Carestream Health CR system.

What is it!?

Win a prize … your own personal EverythingRad coffee mug! You’ll be the envy of your department/imaging center when you flaunt this rare mug (which are almost complete for last month’s winners!). To enter, give us your entry (and your snail-mail address so we can send you your mug) in a comment on this post.

Employees of Carestream Health and their agencies are not eligible to win. (Sorry about that—no mug for you!) We reserve the right to end the contest at any time. And we’ll announce the winners here on Everything Rad.

Why is IHE important for mammography?

When I speak with experienced radiologists about the “old days” of reading film-based mammographic images, they often tell me they are now able to read more efficiently with today’s digital mammography technology. While intuitively you might assume that digital is and always has been better, many of us know that this capability represents a dramatic shift from the early days of digital mammography interpretation—when it wasn’t uncommon for a radiologist to take twice as long as to interpret a digital mammogram.

One contributor to making “soft copy” reading as efficient as film has been the IHE initiative, more formally known as Integrating the Healthcare Enterprise. IHE has played a vital role in creating standards-based integration and viewing of digital imaging modalities for mammography including FFDM, CR for mammography, MRI, ultrasound and other data sets. Most providers have multi-vendor, multi-modality environments that conduct hundreds of exams per day—creating a level of complexity that can only be overcome with well-coordinated, standards-based integration like outlined by IHE.

In addition to system integration, IHE has provided tools that help workflow and quality. As just one example… it has stipulated “image scaling” criteria for digitizing exams as well as different digital mammography modalities, so radiologists can compare current and prior imaging studies side-by-side using their preferred hanging protocols. This both speeds interpretation and enables greater diagnostic confidence.

As you might expect, IHE conformance has become important for technology suppliers. We have worked hard to make our entire mammography imaging chain IHE-compliant including our Mammography PACS, mammographic review workstations, digital imaging systems and printers. Our workstation, for example, enables radiologists to read all types of mammography and other imaging exams—regardless of the imaging modality or system vendor.

In a complex world where too few technologies  “talk” to one another,  IHE is playing a key role in helping providers improve productivity while enhancing service to referring physicians and, ultimately, patients.

What do you think? Is IHE important? Is there anything that IHE is forgetting that we in the industry should be doing?

– Anne Richards, Clinical Development Manager, Women’s Health

Convert portable X-ray exams to DR, FAST!!!

The DRX-Mobile retrofitted with a Siemens Mobilett

Nowhere is the processing of CR cassettes more inconvenient than in a portable environment.

So if hospitals had the ability to quickly and easily convert their existing mobile x-ray systems to DR, would they take it?  Indeed they would, according to healthcare providers who are eagerly waiting for commercial availability of a new retrofit kit that equips popular portable systems to use the wireless, cassette-sized Carestream DRX-1 detector for instant, high-quality DR images.

With the DRX-Mobile Retrofit Kit, images captured at the point of care are available in seconds and can be forwarded to multiple network destinations via wireless communications or cable plug-in, so clinicians can make a rapid diagnosis and begin immediate treatment.

This new technology also improves patient positioning and comfort by eliminating cables and tethers typically required by most DR-based systems. This makes it ideal for confined spaces, remote locations and imaging of patients with limited mobility in addition to emergency rooms, operating rooms and the ICU.

The flexibility of the DRX detector is unprecedented and now it adds another notch in its belt. Facilities that have already implemented a DRX-1 System or a DRX-Evolution suite can use one of their existing detectors for portable exams. Finally, there’s a fast and affordable way to convert portable exams to DR.

Is your facility experiencing higher volumes for portable exams in any area—ER, OR, ICU and inpatients—and if so, what is driving that growth?

– Eileen Heizyk, Digital Capture Solutions, Carestream Health

Editor’s Note: For complete details and a list of portable x-ray systems compatible with the DRX-Mobile Retrofit Kit, please click here. To watch a demonstration video, click here.

Once more, with feeling… (Whew!)

On Friday evening, President Obama signed into law the act to reinstate CMS physician payments to their previous level (without the 21.3% pay cuts which had been scheduled to begin in April). The new law will hold physician payments at their present level till May 31st, 2010, presumably to give the legislature time to pass a more permanent bill. CMS had issued instructions to hold April payments in anticipation of an extension, and from now on April payments will go out uncut. Any payments that went out last week (there were relatively few) will automatically be reprocessed.

According to HIMSS publication Government HealthIT the extension bill (H.R. 4851) also extends eligibility for HITECH incentives to physicians who treat patients in hospital-based outpatient clinics.

We believe a longer-term solution is overdue.  Do you agree? What will it take to convince the legislature to pass a more permanent fix to this situation? Your ideas are welcome.

Ask Anne: Does double reading really improve detection rates in screening mammography?

As someone who has watched numerous debates about mammography screening transpire, there’s one “standard” that we can all agree on: double reading, of any kind, improves detection rates and can save lives.

Numerous studies lend evidence to the effectiveness of double reading*—whereby at least two radiologists interpret the same mammographic examination. More recently, computer-aided detection (CAD) has emerged as a way to utilize sophisticated software to highlight suspicious areas, enabling the radiologist to examine these areas a second time to maximize accuracy.

Screening conventions around the world differ extensively. In Europe, for example, double reading is a common practice in more than a dozen countries. Many of these countries, in addition to Australia, New Zealand and Canada, practice “population-based” screening, whereby a centralized screening or health organization formally invites women to participate in screening at a pre-determined age. Once a woman enters into the system, population- and age-based metrics can be tracked including program participation, detection and mortality rates, and more.

In the U.S., where screening is provided in diverse settings that include private clinics, hospitals settings and academic medical centers, double reading is used but not mandated. Fortunately, most U.S. insurance companies now include CAD as part of their regular screening coverage.

As a women’s imaging technology supplier, our goal is to provide tools that support the myriad screening reading conventions that exist worldwide. When examining imaging and information systems for double reading, look for RIS or PACS that can drive an efficient workflow for two different reads for a single patient—with the ability to automatically flag and/or recall patients when there are contradictory findings.

If you’d like to add CAD, look for a PACS platform that integrates with robust digital CAD software—which allows radiologists to read the exam and then activate the CAD analysis. Ultimately, you should develop a workflow that not only helps you report but also enables you to track double-reading results for regular medical outcomes audits of the mammography practice for ongoing self-assessment.

What screening reading conventions does your facility/country adhere to? How can we better support you?

– Anne Richards, Clinical Development Manager, Women’s Healthcare

* There are numerous studies supporting double reading, including:

  • Gilbert, FJ, Astley, SM, Gillan, M, Agbaje, O F, Wallis, M G, James, J, Boggis, C, Duffy, S W, Single reading with Computer-Aided Detection for screening Mammography. NEJM 2008, Volume 359:1675-1684.
  • Thurfjell E, Lernevall K, Taube A. Benefit of independent double reading in a population-based mammography screening program. Radiology 1994;191:241-244.
  • Ciatto S, Del Turco M, Morrone D, et al. Independent double reading of screening mammograms. J Med Screen 1995;2:99-101.
  • Anttinen I, Pamilo M, Soiva M et al. Double reading of mammography screening films- one radiologist or two? Clin Radiol 1993;48:414-421.

Editor’s Note: “Ask Anne” is a new monthly installment in which we pose a mammography-focused question to Carestream Health Women’s Health Clinical Development Manager and all-around mammography expert, Anne Richards. Got a question for Anne? Add it in the comments section below!

Carestream point of view: Meaningful use should include image storage

The Federal incentives to digitize medical records and make patient information accessible across platforms should extend to radiology images.  We agree with Charles Rosen, MD, PhD, professor of neurosurgery at West Virginia University School of Medicine in Morgantown, quoted in a recent CMIO article “imaging is a fundamental part of modern medicine.” 

The American College of Radiology (ACR), American Board of Radiology, Radiological Society of North America and the Society for Imaging Informatics in Medicine have submitted comments to the Department of Health and Human Services (HHS) on what constitutes meaningful use of certified EHR technology and are recommending the inclusion of image storage and archiving as part of the program. We encourage you to visit the HHS website and make your feelings known on this issue.

Let us know how you feel with a comment!