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Radiology News
Make CT Scans Part of Lung Cancer ScreeningPatients at high risk for lung cancer should have regular screening with low-dose CT scans, according to guidelines issued by a consortium of the nation's major cancer centers. Team ACLS: The physicians at NYMI successfully completed a half day course, in accordance with the curriculum of the American Heart Association for the Advanced Cardiovascular Life Support Program.
November 16, 2010 - CT Scans Cut Lung Cancer Deaths, Study FindsWASHINGTON — Annual CT scans of current and former heavy smokers reduced their risk of death from lung cancer by 20 percent, a huge government-financed study has found. Even more surprising, the scans seem to reduce the risks of death from other causes as well, suggesting that the scans could be catching other illnesses. The findings represent an enormous advance in cancer detection that could potentially save thousands of lives annually, although at considerable expense. Lung cancer will claim about 157,000 lives this year, more than the deaths from colorectal, breast, pancreatic and prostate cancers combined. Most patients discover their disease too late for treatment, and 85 percent die from it. No screening method had proved effective at reducing mortality from the disease. Four randomized controlled trials done during the 1970s showed that chest X-rays, while they helped catch cancers at an earlier stage, had no effect on overall death rates. Since then, researchers have suggested that CT scans — which use coordinated X-rays to provide three-dimensional views — could detect lungtumors at an even earlier stage than X-rays. “This is the first time that we have seen clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial,” said Dr. Christine Berg of the National Cancer Institute. Cancer doctors and others predicted that the study’s results would soon lead to widespread use of CT scans, in particular for older smokers, who have a one in 10 chance of contracting lung cancer. “These people are worried about lung cancer, and now there is an opportunity to offer them something,” said Dr. Mary Reid, an associate professor of oncology at the Roswell Park Cancer Institute in Buffalo. But health officials involved in the study refused to endorse widespread screening of current or former smokers, saying more analysis of the study’s results is needed to further identify who benefited most. Such an analysis is months away. And they pointed out that the study offers no reassurance about the safety of smoking or the advisability of CT scans for younger smokers or nonsmokers. “No one should come away from this thinking that it’s now safe to continue to smoke,” said Dr. Harold E. Varmus, director of the National Cancer Institute. Patients wishing to get a CT lung screen will most likely have to pay the roughly $300 charge themselves, since few insurers pay for such scans unless an illness is suspected. The federal Medicare program will soon reconsider paying for such screens, a Medicare official said. The study, called the National Lung Screening Trial, was conducted by the American College of Radiology Imaging Network and the cancer institute. It involved more than 53,000 people ages 55 to 74 who had smoked at least 30 pack-years — one pack a day for 30 years or two packs a day for 15 years. Ex-smokers who had quit within the previous 15 years were included in the group. Each was given either a standard chest X-ray or a low-dose CT scan at the start of the trial and then twice more over the next two years. Participants were followed for up to five years. There were 354 lung cancer deaths among those who received CT scans and 442 among those who got X-rays. The $250 million study, which began in 2002, was paid for by the cancer institute and carried out at 33 sites. Its preliminary results were announced days after an independent monitoring board determined that the benefits of CT scans were strong enough to stop the trial. The study will be published in the coming months. The study found that for every 300 people who were screened, one person lived who would otherwise have died during the study. But one-quarter of those given CT scans were found to have anomalies, nearly all of which were benign. These false signals generally led to more worry, more CT scans and sometimes to lung biopsies and thoracic surgery. “There are economic, medical and psychological consequences of finding these abnormalities,” Dr. Varmus said. Dr. Claudia Henschke, a clinical professor of radiology at Mount Sinai Medical Center and a longtime advocate for use of CT to screen for lung cancer, said the study was likely to have underestimated the benefits of CT scans because participants were screened only three times. Had the screening continued for 10 years, as many as 80 percent of lung cancer deaths could have been averted, she said. Dr. Henschke’s research has been controversial because of its statistical methods and its financing, which included money from a tobacco company. She earns royalties from makers of CT machines. “What we also have found is that low-dose CT scan gives information on cardiovascular disease, emphysema” and other pulmonary diseases, Dr. Henschke said. “Those are the three big killers of older people. There is just tremendous potential.” “If we look at this study carefully, we may suggest that there is some benefit in high-risk individuals, but I’m not there yet,” Dr. Patz said. Since 46 million people in the United States smoke and tens of millions more once smoked, a widespread screening program could cost billions annually. Any further refinement of those most at risk could reduce those costs. Low-dose CT scans expose patients to about the same radiation levels as mammograms. Little is known about how the cumulative risks of years of such scans would balance the benefits. The study’s results could have both legal and political consequences. Suits against tobacco companies have sought to force cigarette makers to pay for annual CT screens of former smokers. But with the science uncertain, those claims have so far been rebuffed. Congress has diverted some research money to create pilot CT lung screening programs, diversions that may gain momentum now. Some Obama administration officials argued during the debate on the health care law that patients’ health was often harmed by getting too many tests and procedures that, if reduced, would improve health while reducing costs. This study suggests that, at least in lung cancer, spending more on tests saves lives. Laurie Fenton, president of the Lung Cancer Alliance, which has lobbied for widespread CT lung screening, said the debate about the advisability of such scans is now over. “The challenge now shifts from proving the efficacy of the method to developing the proper quality standards, infrastructure and guidelines to bring this needed benefit to those at high risk for the disease — now,” Ms. Fenton said. But Dr. Peter B. Bach, a pulmonologist at Memorial Sloan-Kettering Cancer Center in New York, said no one should rush out and get a CT scan yet because further analysis will better define whom the screening helped. “Very soon we’ll have an answer about who should be screened and how frequently,” Dr. Bach said, “but we don’t have that answer today.” Source: www.nytimes.com Editorial comment from NYM Editors: " This review supports our contention that CT trumps Chest X-ray in screening persons at risk, such as smokers and industrial workers."
October 14, 2010 - NYMI Associates have been designated as one of the few ACR Breast Imaging Center of Excellence facilities.By awarding facilities the status of a Breast Imaging Center of Excellence, the ACR recognizes breast imaging centers that have earned accreditation in mammography, stereotactic breast biopsy, and breast ultrasound (including ultrasound-guided breast biopsy). Peer-review evaluations, conducted in each breast imaging modality by boardcertified physicians and medical physicists who are experts in the field, have determined that this facility has achieved high practice standards in image quality, personnel qualifications, facility equipment, quality control procedures, and quality assurance programs. The ACR is a national professional organization serving more than 34,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians, and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services. ACR ACCREDITED MODALITIES INCLUDE:
Feel free to contact one of our Breast Imaging Specialist: Barry D. Berson M.D. Jolinda Mester M.D. Michael Mecca M.D.
March 9, 2009 - Virtual Colonoscopy Roll-backOn February 11, 2009, the Centers for Medicare and Medicaid Services (CMS) proposed not to cover computed tomography colonography (CTC) for colorectal cancer screening for Medicare patients. This decision comes despite the overwhelming evidence from the 2008 ACRIN CTC trial that shows virtual colonoscopy is just as effective as optical colonoscopy at detecting polyps >10mm that require removal. The ACR, along with the American Gastroenterological Association, the Colon Cancer Alliance, and the American Cancer Society are working to reverse CMS’s decision not to cover this important non-invasive screening tool as an option for Medicare patients. We need your help. Your Member of Congress has the opportunity to weigh in with Medicare by signing on to a letter being circulated by Rep. Kay Granger (TX) and Rep. Patrick Kennedy (RI) that will be sent to the agency urging that they cover CTC as a screening option. Please call your House Member and ask him/her to sign on to the Granger—Kennedy letter to CMS regarding coverage for virtual colonoscopy for colon cancer screening. What you may point out to your Member of Congress: CMS is about to make a huge mistake and limit the options for Medicare patients seeking to get screened for colon cancer. Colon cancer is the third most common cancer in the United States and the second leading cause of cancer deaths. Screening rates for colon cancer lag behind both breast cancer and cervical cancer as only 50% of eligible seniors are getting necessary screening. Colon cancer is very curable if detected, therefore no one should die from this disease. Public health officials and physicians believe that the invasiveness of the optical colonoscopy may act as a barrier for those who should be screened. In order to provide alternatives to the colonoscopy, physicians have developed the virtual colonoscopy which can detect colon cancer and polyps that need to be removed via CT imaging. This technology has been evolving and improving for over 18 years. The evidence is now here to warrant coverage for virtual colonoscopy for colon cancer screening by Medicare. Despite recent published evidence from a national clinical trial showing virtual colonoscopy’s comparable effectiveness to the standard colonoscopy, Medicare has proposed not to cover this non-invasive option. Along with the radiology community, the American Gastroenterological Association, the Colon Cancer Alliance, and the American Cancer Society all support coverage. Other areas of the government recognize the benefit of virtual colonoscopy. The Department of Defense has large volume screening programs using virtual colonoscopy at Walter Reed Army Medical Center and the National Naval Medical Center. Walter Reed has determined their program to be a success and is working with the Department of Veterans Administration to deploy virtual colonoscopy screening throughout the VA Health System. Medicare patients deserve the same access to colorectal cancer screening. "I ask that Congressman/woman ... please sign on to the Granger—Kennedy letter to CMS urging the agency to reconsider their decision not to cover this valuable screening tool."
May 6, 2008 - BRAINLAB Image Guidance for Endoscopic Sinus Surgery.Upon request from your ENT surgeon, we will submit a special set of your sinus CT images directly to BrainLab for processing into a 3D virtual display. The data will be used during surgery as a virtual guide to the nasal passages. Please address any questions to Tina Opong (212) 535-9770 or e-mail: ahyman@makimaging.com
October 22, 2007 - VIRTUAL 3D COLON CHECKS OUT!"Researchers at the University of Wisconsin School of Medicine have found that non-invasive CT colonography, which creates a 3D computer scan of the colon, can detect advanced polyps-the precursors to colon cancer- just as accurately [as conventional colonoscopy]." Health Watch, U.S. News and World Report , October 15, 2007 |
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