La imagen de rayos X digital inalámbrica mantiene el ritmo con los pilotos de MotoGP de movimiento rápido

El Detector DRX-1 de CARESTREAM y Clinica Mobile ofrecen a los pilotos de MotoGP y WSBK rápidos resultados diagnósticos

Michele Zasa, Medical Director, Clinica Mobile

Leggi questo blog in Italiano   Read this blog in English

Cuando se corre alrededor de una pista de MotoGP o World Superbike a casi 200 mph, las lesiones son inevitables. Afortunadamente, el personal de Clinica Mobile tiene su propio recurso rápido: el detector CARESTREAM DRX-1. El detector de rayos X digital inalámbrico crea exposiciones radiografía en cuestión de segundos.

competidores de MotoGP y World Superbike [radiografía]

Los detectores inalámbricos ayudan a acelerar los diagnósticos de los competidores de MotoGP y World Superbike [#radiografía]

Clinica Mobile es un centro médico y de fisioterapia móvil totalmente equipado para los circuitos de MotoGP y World Superbike (WSBK). Los principales ases de motocicletas del mundo, como Marc Márquez, Balentino Rossi y Jonathan Rea, acuden a nuestra clínica móvil para el diagnóstico y tratamiento de lesiones menores. El Detector DRX-1 inalámbrico de Carestream nos da acceso instantáneo a imágenes de rayos X, acelerando nuestros diagnósticos y decisiones sobre el cuidado del paciente.

 El detector DRX-1 facilita el diagnóstico rápido

Podemos colocar y ajustar fácilmente el detector de imágenes bajo el brazo, la pierna o cualquier otra área que necesite imágenes. El detector de rayos X digital envía la exposición de forma inalámbrica a la consola en unos pocos segundos. Un cargador de batería independiente permite que el detector se utilice mientras se carga una batería de repuesto.  Continue reading

Accreditation for Cone Beam Orthopaedic Imaging: Answers to 7 Questions

Providers must be accredited by a CMS-approved organizationCarestream OnSight 3D Extremity System

Donald Thompson , Carestream Health

The process for securing accreditation for Cone Beam CT orthopaedic imaging can be a bit confusing. However, it’s a necessary process. Any facility performing CT scans must obtain accreditation prior to receiving reimbursements from Medicare and many private payers.

The process for securing accreditation is worth it. Adding the capability for in-house cone beam CT exams can have major benefits for orthopaedic practices. It can help speed your workflow, boost your productivity, and support a higher standard of care. It can even help differentiate your practice from the competition.

Read on to learn the simple answers to 7 common accreditation questions. Continue reading

Carestream OnSight 3D Extremity System Gains FDA 510(k) Clearance

Aunt Minnie Selects OnSight Product as Finalist for “Best New Radiology Device”

Helen Titus, Carestream Health

Editor’s note: the CARESTREAM OnSight 3D Extremity System was named the winner for Best New Radiology Device by Aunt Minnie in October!

September has been a big month for our CARESTREAM OnSight 3D Extremity System. The product received FDA 510(k) clearance and is available for order in the United States. It was also selected as a Finalist for “Best New Radiology Device”by Aunt Minnie. The publication chose the product in part because of the niche it fills – “a small CT scanner designed for extremity studies”.Carestream OnSight Aunt Minnie finalist

This affordable, compact system offers high-quality, lower-dose 3D imaging studies (compared to traditional CT) for use by orthopaedic and sports medicine practices, hospitals, imaging centers, urgent care facilities and other healthcare providers. The system also comes with 3D software from Carestream designed to give orthopedic specialists more information on pathology than what might be possible with 2D imaging.

The extremity imaging system can help in treating a host of orthopaedic conditions that affect the biomechanical behavior of the joints such as arthritis, meniscus loss, instability and malalignment syndromes. The system also offers less radiation than traditional CT systems while delivering excellent image quality.

A key feature of the product is its ability to capture weight-bearing images. Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo recently concluded a study, noting the benefit of weight-bearing images for orthopaedic patellofemoral diagnosis.

Orthopaedic imaging is a major focus for Carestream because of the prevalence of musculoskeletal conditions among people of all ages. Youth and adults often suffer sports-related injuries to their knees, ankles and feet while older adults experience arthritis, joint instability, meniscus loss and other conditions.

Carestream’s new extremity imaging system enables healthcare providers to capture high-quality 3D images and conduct a patient consultation in a single visit—which helps improve productivity and convenience for both specialists and patients. An additional benefit is the ability for patients to view a 3D image that illustrates their condition or injury to help them understand the reason for a treatment or surgical procedure.

The OnSight 3D Extremity System will be demonstrated at the American Society for Surgery of the Hand (ASSH) conference that begins on Sept. 29.

#NHITweek

Editor note: In Europe, the device cannot be marketed or sold until compliant with 93/42/EEC.

 

Helen Titus

Helen Titus is the worldwide X-ray & Ultrasound Solutions Marketing Director at Carestream

Research: Impact of Weight-bearing Images in Orthopaedic Imaging

Study favors weight-bearing images for orthopaedic patellofemoral diagnosis and surgery

Dr. John Marzo, UBMD Orthopaedics & Sports Medicine

In clinical orthopedics advanced imaging like computed axial tomography (CT) scanning, has become invaluable to the evaluation and management of patients with musculoskeletal disease. Bone detail is much better visualized with 2D and 3D CT renderings of patients with problems like glenoid fracture, failed shoulder instability surgery, and meniscal root avulsions.

Conventional CT technology requires subject in supine position

High-quality images provide multiplanar 2D and 3D visualization for practitioners who think and work in three dimensions. However, a significant limitation of CT technology has been that it forces image acquisition with the subject in a supine, relaxed position. When imaging an injured knee, for example, the leg is in full extension and the muscles relaxed.

The conventional measures of patellofemoral alignment include the congruence angle, patellar tilt angle, and tibial tubercletrochlear groove offset distance. There are clearly defined limits of normal use for each of these measures, and they are used by surgeons to plan corrective operations on the patellofemoral joint. The degree of knee flexion and activity of the quadriceps are known to influence patellar tracking on the trochlea, but these factors are removed when images are taken with the patient supine.

Some have tried to simulate weight bearing in a CT scanner by custom designing a rig to apply longitudinal  load  through  the  patient  for  imaging  of  the  spine or  lower  extremity. These  methods  are  at worst,  a  poor depiction  of  functional  anatomy;  and  at  best , a cumbersome  and a less-than-accurate simulation of function.

Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo undertake study

Myself and other researchers from the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo are currently performing research on a new  cone  beam CT scanner,  the  CARESTREAM OnSight  3D  Extremity  System,  developed by Carestream Health. The system is designed to offer high-quality, portable,  low-dose  3D  point-of­ care imaging by orthopaedic and sports medicine practices, hospitals, imaging centers, urgent care facilities, and other healthcare providers.

We have been performing institutional IRB-approved clinical trials and basic sciences studies with the prototype model. These studies are being carried out at the Erie County Medical Center, Buffalo’s regional orthopedic tertiary care facility. Based on early data, we are convinced that many imaging studies should be acquired with subjects in positions that represent true human function, such as weight bearing on the lower extremities.

Comparing Carestream OnSight 3D Extremity System to predicate devices

We compared the 2D imaging performance of the CARESTREAM OnSight 3D  Extremity System to the predicate CARESTREAM DRX-1 Detector used with the CARESTREAM DRX-Evolution System. We compared the 3D volumetric imaging performance of the OnSight system to a multiple detector computed  tomography (MDCT) scanner  (“predicate device”). The purpose of the study was to demonstrate equivalent diagnostic  image quality between the investigational and predicate devices, using a Radlex subjective quality rating scale.

The evaluation was performed on equal numbers of knees, ankles, feet, elbows, and hands from 33 cadaveric human specimens and 13 living human subjects. Four independent, board-certified radiologists of varying general reading experience performed evaluations of the images/exams captured using both the investigational and predicate devices.

Results: OnSight 3D Extremity System produced 2D images with equivalent diagnostic image quality to predicate system

In summary, the CBCT system produced 2D images with equivalent diagnostic image quality to the predicate system for a range of exams, and 3D images were rated equal or better when compared to the predicate device for a range of exams on cadaveric specimens and human subjects.

  • More than 80% of all the 2D images were rated diagnostic or exemplary, whereas approximately 98% of all 3D images were rated diagnostic or exemplary.
  • More than 75% of all Radlex rating responses counted for all 2D images were rated equivalent or favored the investigational device.
  • Approximately 85% of the Radlex rating responses counted for the 3D images were rated equivalent or favored the investigational device.

Examples of representative scans are seen below.

2D and 3D orthopaedic renderings generated by the CBCT scanner

Figure 5: 2D and 3D renderings generated by the CBCT scanner

Our conclusion from this study is that for cases of patella instability, it may be desirable to obtain images while the patient is weight bearing on a flexed knee with their quadriceps muscles active. Improvement in objective measures of patella alignment should lead to improved clinical and surgical care of patients with this condition.

New study: comparing measures of ankle stability

A second clinical study is currently under way to take advantage of the unit’s ability to obtain images in weight bearing. The research will compare measures of ankle stability from the investigational weight-bearing cone beam computed tomography scanner to the same measures on gravity stress X-ray in patients who have supination-external rotation ankle fractures.

These and future studies may validate the value of the OnSight 3D Extremity System. Potential benefits include better quality images with a lower radiation dose than conventional computed tomography. The unit is proposed for use in orthopedic offices, but it might have applications to the operating room or at athletic competition sites. The unit is less expensive than a traditional in-hospital or radiology center CT scanner, and can be used with existing electrical systems (220V). Most important however, is the potential to acquire images while bearing weight and in more functionally relevant positions.

Editor’s note: The CARESTREAM OnSight 3D Extremity System received FDA 510(k) clearance in September 2016 and is available for order in the United States.

Dr. John Marzo, UBMD

Dr. John Marzo is a physician with UBMD Orthopaedics & Sports Medicine, Associate Professor of Clinical Orthopaedics, Jacobs School  of  Medicine  and  Biomedical  Sciences,  University at Buffalo and  former  Medical  Director,  Buffalo Bills. He is also a member of Carestream’s Advisory Group, a collective of medical professionals that advises the company on healthcare IT trends.

Diagnostic Reading #33: Five “Must Read” Articles on HIT and Radiology

The role of imaging in stress tests and MTBI; and the cost of health IT are in the news

Articles include: zero-gravity treadmills beneficial for stress tests; plans that don’t require pre-authorization for radiology imaging are a worst-case scenario; a type of MRI might be effective in assessing mild traumatic brain injury (MTBI); healthcare IT systems and technology cost physicians anRunning on treadmill average of $32,000 a year; and seniors are not embracing digital technology for healthcare management.

Study uses NASA technology for heart health tests – Health Imaging

A new study could give physicians a better understanding of patients’ cardiac health. To combat the burden that traditional treadmill exercise places on patients, physicians are using zero-gravity treadmills in stress tests. The treadmills can reduce patients’ weight by 25 to 50 percent, making it much more comfortable for them to walk for the amount of time necessary to reach a stress test-level heart rate. Then doctors can use normal imaging techniques to take pictures of the heart and its blood supply to determine the patient’s condition.

How to improve patient care and get paid for it too – Health Imaging

It’s a paradox. Procedures listed by payers as “no pre-authorization required” are among the most commonly denied for payment after they’ve been completed. Part of the problem is the general unwillingness of payers to authorize procedures they’ve listed this way. The radiology stakeholders on the short end of this stick include referring physicians along with patients and radiology services providers.

Imaging Predicts Long-Term Effects in Veterans With Brain Injury – Radiology Today

A type of MRI – diffusion tensor imaging (DTI) – might be able to predict post-deployment outcomes for veterans who sustained mild traumatic brain injury (MTBI) or a concussion during combat, according to a study. Current assessment of MTBI remains challenging due to the difficulties in separating the effects of MTBI from other conditions like post-traumatic stress disorder. DTI uses measurements of water movement in the brain to detect abnormalities, particularly in white matter. Previous studies have linked DTI metrics to neurocognitive function and short-term functional outcomes in groups of patients

Health IT now costs $32,000 per doctor, annually – DotMed Healthcare Business News

A new survey reveals that the move to digitization costs more than $32,000 per doctor per year. Physician-owned multispecialty practices spent more than $32,500 per full-time physician on information technology equipment, staff, maintenance and other related expenses in 2015. That’s a whopping 40 percent bump up for IT costs for doctors since 2009 – the last year before new regulations ushered healthcare into the digital era.

Digital health technology not popular among seniors – Health Data Management

Seniors might be the sickest, most expensive and fastest growing segment of the U.S. healthcare population, but they are not embracing digital technology for healthcare management. A new study of Medicare beneficiaries over age 65 is underway to gather data about how seniors are using digital health.

#HIT #Radres

Diagnostic Reading #17: Five “Must Read” Articles

Health imaging, contact sports and patient engagement are in the spotlight

This week’s articles include: a radiologist spearheads improvements at a Texas hospital; measurable changes can occur inside young athletes’ brains in a single season of contact sports; patient engagement is becoming essential to getting maximum payment for services; a study reports that one-third of radiology recommendations went unacknowledged at a Boston facility; and admissions growth for U.S. hospitals is unlikely to be repeated in 2016.

How radiologists can lead the way in healthcare quality improvement – Health Imaging

When quality improvement efforts at the Baylor College of Medicine stalled out due to multiple staffing disruptions and a general lack of coordination, it was a radiologist who took the challenge head-on, according to Emily Sedgwick, MD, an assistant professor and author of a recent article in the Journal of the American College of Radiology.

Changes to brain cells measurable after one season of high school football – Health Imaging Carestream-head-trauma

A single season spent playing contact sports is all it takes for measurable changes to occur inside young athletes’ brains, according to results of a study recently published in the Journal of Neurotrauma. Researchers from the University of Texas Southwestern Medical Center in Dallas used helmets capable of recording data related to head impacts, then used MRI and diffusional kurtosis imaging to measure changes in neural cellular structures. They found that even when no concussion occurs, athletes experience neurological changes at the cellular level after just one season. Continue reading

Overcoming Limitations of CT for Orthopaedic Imaging of Extremities

Weight-bearing images show pathologies more clearly

John Yorkston, PhD, Carestream Health

Musculoskeletal and orthopaedic disorders are without prejudice. They plague the sports professional, the weekend athlete and even sedentary office workers, increasing the demand for orthopaedic imaging.

According to the United States Bone and Joint Initiative, 77% (65.8 million) of all injury health care visits are for musculoskeletal injuries. And OSHA estimates that work-related musculoskeletal disorders in the United States account for over 600,000 injuries and illnesses. The injuries can cause pain, limit activities and require surgical repair and/or physical therapy.

Imaging the extent of these injuries, ranging from carpal tunnel to meniscus loss, has been challenging. The reason: traditional computed tomography (CT) has a significant limitation. It requires multiple rotations –and it cannot capture a weight-bearinCarestream OnSight 3D Extremity Systemg image. However, new cone beam CT (CBCT) technology from Carestream removes these restrictions. The CARESTREAM OnSight 3D Extremity System, designed to offer high-quality, low-dose 3D point-of-care imaging  by orthopedic and sports medicine practices, hospitals, imaging centers, urgent care facilities and other healthcare providers.CBCT, first described in the late 1970s, is a variant of traditional computed tomography. The main difference between the two approaches is the volume of the object that is imaged at one time. In traditional CT, a narrow slice of the patient is imaged with a “fan beam” of X-rays. For an extended volume of the anatomy via CT, the patient must be imaged multiple times through the fan of X-rays as it rotates. In contrast, in CBCT, a large-area detector images an extended volume of the patient in a single rotation, reducing the complexity of the mechanical design of the system.

Continue reading

Diagnostic Reading #15: Five “Must Read” Articles on Brain Injuries in the NFL and Healthcare Data from the Past Week

Unstructured data and radiologists’ adoption of technology are in the news

 

This week’s articles on #healthcare data and #radiology include: more than 40% of retired #NFL players might have traumatic brain injuries; 80% of big health data is unstructured and “invisible” to healthcare organizations; scientists are gaining unprecedented tools for understanding the genetic roots of cancer; engaging radiologists is key to a successful standardized structured reporting program; and efforts are underway to make customer relationship management a central component in the population health ecosystem.

Imaging study: More than 40% of retired NFL players may have traumatic brain injuries – HealthBrain injuries Imaging

Nearly half of retired National Football League players might suffer from traumatic brain injuries, according to re
sults of a diffusion tensor imaging study scheduled to be presented at the annual meeting of the American Academy of Neurology in Vancouver, Canada.

Providers need new tools to make sense of unstructured data – Health Data Management

Healthcare is being inundated with a deluge of big health data, 80 percent of which are invisible to current computing systems because the data are unstructured, according to IBM. Unstructured data includes doctors’ notes, wearables, X-rays, social media, the weather, sensors and sound.

Continue reading

Sports Medicine Enhancing Care for Amateur and Professional Athletes

Carestream Sports MedicineMany young football players dream of playing in the NFL. My dream was to work for an NFL team and care for the medical needs of these skilled athletes.

Anyone who has watched an NFL game has seen the elite athleticism—and its potential for injuries. Our job as athletic trainers is to help prevent, evaluate and treat conditions ranging from concussions to soft tissue sprains and strains, fractures/dislocations and internal injuries. We also care for our share of chronic conditions.

A Carestream digital X-ray system at Lambeau Field can deliver excellent images in seconds. Our staff provides these images to our team physicians and other specialists who diagnose the injury and determine whether a player can return to the “action” or is in need of further evaluation or urgent care.

Many spectators don’t realize the medical expertise that is available on the sideline for every game—which includes orthopaedists, internal medicine specialists, neurosurgeons, emergency room physicians and neuropsychologists. These experts can view images on the sideline using their iPads and make critically important medical treatment decisions in seconds.

As athletic trainers, game days are just a small aspect of our weekly routine. We monitor our players’ healthcare all year—from the last whistle of the season through the off-season program and back through another long season. We work closely with our physicians to provide optimal and personalized care for each player. Using baseline concussion testing, body composition and multiple physical exams, we are always on the lookout for conditions and injuries that may not present immediate symptoms.

Every year athletic training and physical therapy professionals are exposed to the latest imaging, diagnostic and treatment technologies that can help enhance patient care. We are seeing a tremendous growth in the number of individuals who pursue these careers, which will help enhance the health of amateur to professional athletes for years to come.

Pepper Burress, Green Bay PackersPepper Burruss was named Director of Sports Medicine Administration for the Green Bay Packers in June. He was the team’s Head Athletic Trainer for 22 years and is a Certified Athletic Trainer and Physical Therapist. He also worked for 16 seasons with the New York Jets as an Assistant Athletic Trainer. Burruss has won several awards during his career, including being honored as the NFL Physicians Society’s Outstanding NFL Athletic Trainer for the 2012 season. In 2011, he and his staff were named the NFL’s Athletic Training Staff of the Year.

International Day of Radiology: Reminding Us About the Importance of Treating TBIs

The International Day of Radiology is an initiative organized by the ESR, RSNA, and ACR.

The International Day of Radiology is an initiative organized by the ESR, RSNA, and ACR.

This year’s focus on the International Day of Radiology is brain imaging. It is an important topic as stories about traumatic brain injuries (TBI) continue to dominate healthcare news, and for good reason.

We posted information earlier this year concerning  how many TBI are occur in the U.S., as well as how many incidences there are  among high school athletes. This high number among young athletes is particularly alarming since TBI experienced at a young age can have a lasting impact if not detected and treated immediately.

There are many TBI cases where a patient would not have long-lasting symptoms and life-long disabilities if the TBI was detected and treated sooner. TBI, while always serious, have different levels of severity. The Mayo Clinic defines a TBI occurring

“…when an external mechanical force causes brain dysfunction. Traumatic brain injury usually results from a violent blow or jolt to the head or body. An object penetrating the skull, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.”

From a minor concussion, to blunt force trauma, a TBI must be treated with utmost care or else patients are at risk of experiencing prolonged health issues.

As shown in the infographic created by UPMC, the age groups that are most likely to sustain a TBI are children 0-4, adolescents 15-19, and adults 65 and older. The first two segments are particularly alarming, as TBI sustained in these age segments can have a lasting negative effect on person’s mental development.

Our infographic back in August highlighted the seriousness of TBI in high school sports. One source said that 1 in 10 high school athletes will suffer a concussion this year, and high school age athletes can take longer to recover, and may be more vulnerable to re-injury if they continue playing before full recovery. With 3% of those sustaining multiple concussions developing longterm brain damage, that amounts to an estimated total of 114,000 people with longterm brain damage as 3.8 million incidences of sports-related concussions occur every year.

At Carestream, we are working aggressively to do our part in the detection and treatment of TBI. We announced a partnership with UBMD Orthopaedics & Sports Medicine in October to collaborate on development of a new three-dimensional medical imaging system for extremity imaging. Our plan is to later expand this joint research project to focus on developing a CBCT system with image quality that is suitable for assessing and treating TBI, with the goal of aiding Carestream’s understanding of the use of advanced medical imaging technology in early detection and monitoring of TBI.

Diana Nole, Carestream HealthDiana L. Nole is the President of Carestream’s Digital Medical Solutions division.