ACR Bulletin October 2019
A Living Streak
A patient recounts his journey undergoing treatment for lung cancer — and how it changed his outlook on life.
James Hiter Jr. is pictured with his German shepherd, Branko.
After 723 days of running every day with my German shepherd, Branko, I didn’t have time to be sick. But I was sick. I had just returned from a business trip out West and I felt awful. My family doctor diagnosed me with bronchitis and the flu and I needed antibiotics to get over it. He ordered a chest X-ray to rule out pneumonia. While the X-ray didn’t show pneumonia, it did reveal a mass — about the size of a tennis ball.
A long-time radiology advocate has always seen the value in connecting with patients.
“Many radiologists are faced with being more isolated and more disengaged with patient care.” This is a reality that shouldn’t be ignored — and one the ACR is working to change, says Raymond K. Tu, MD, MS, FACR, who was recently recognized by the Council of the District of Columbia for his work on healthcare disparities and the underserved.
Two radiology residents look back on their experiences with the ACR Foundation’s Goldberg-Reeder Travel Grant.
The ACR Foundation’s Goldberg-Reeder Travel Grant ProgramTravel Grant Program is designed to facilitate knowledge sharing while assisting patients in low- and middle-income countries. The latest group of recipients brought their skills, expertise, and energy to Uganda and Malawi, where they worked with local colleagues and patients to advance radiological care. Fresh from their travels, the recipients shared their insights and experiences with the Bulletin.
The medical physics community is leading the effort to simplify the CT protocol.
With all of the daunting obstacles — economic viability, primary care provider buy-in for shared decision-making, and population disparities, to name a few — establishing a lung cancer screening (LCS) program is challenging. However, the medical physics community is championing the effort to simplify at least one element of the LCS program: the CT protocol.
How can radiologists become champions for lung cancer screening?
A New Frontier
The Society of Breast Imaging’s journal is moving the needle forward on the science of breast screening to improve patient care.
In the world of academic publishing, there is no shortage of journals. However, surprisingly, none were breastimaging specific — that is until the Society of Breast Imaging (SBI) and Oxford University Press announced a partnership in March to publish the Journal of Breast Imaging (JBI), the first and only peer-reviewed journal to focus solely on breast imaging (bit.ly/SBI_JBI). The JBI aims to publish original research from around the world with the ultimate goal of saving lives and minimizing the impact of breast cancer.
Managing the Misinformation
A newly launched mammography toolkit will help providers identify reliable breast cancer screening information.
What is the best age to start breast imaging? How often should patients be screened? Do you even need to worry about mammograms if you do not have a family history of breast cancer? While these questions might seem simple, finding definitive answers is complicated. Even more troublesome is when entirely capable and trustworthy providers are also peddling information that is not informed.
Word of Mouth
Lung cancer screening advocates are urging providers to share the message with their patients — low-dose CT saves lives.
The evidence that lung cancer screening (LCS) improves mortality has increased considerably in the past year — yet this lifesaving strategy continues to be underused. This assessment is the impetus for the ACR, many of its radiologists, and a supporting cast of healthcare professionals who are determined to break down the barriers between LCS programs and the patients who need them.
Reducing Lung Cancer Deaths
ACR’s LCS 2.0 Steering Committee is addressing the barriers, identifying solutions, and empowering radiologists to lead efforts to increase low-dose CT adoption.
There is an ever-growing body of evidence that lung cancer screening (LCS) with low-dose CT (LDCT) is effective. Most in the medical community were delighted when the results of the National Lung Screening Trial in 2011 showed a 20% reduction in lung cancer mortality with LDCT and with the subsequent Grade B recommendation from the U.S. Preventive Services Task Force. This milestone led to insurance and Medicare coverage for LDCT as a preventative service in eligible patients — which meant eligible patients could receive LDCT with no cost sharing or co-pay required.
A Review of Rule-Making
The Commission on Economics has provided rule-making comments for decades.
One of the core activities of the Commission on Economics is engagement with CMS on Medicare payment policy. This occurs on multiple fronts, but it largely centers on the regulatory, rule-making process. CMS is required to share updates to its payment systems through annual proposed rules, a process which allows for a public comment period before a final rule is released. Any member of the public may submit comments, and the ACR does so on behalf of our members and the radiology profession. Proposed and final rules are released for the Medicare Physician Fee Schedule (MPFS), the Quality Payment Program (QPP), the Hospital Outpatient Prospective Payment System, and the Inpatient Prospective Payment System, among others. The Commission reviews each of these documents. This task is not a small one. Every year, CMS releases around 10,000 pages of rule-making documents. For 2020, the MPFS and QPP Notice of Proposed Rule-Making (NPRM) document is more than 1,700 pages long.