Dispatches: News From the ACR and Beyond

July 2017DispatchesOct

Imaging 3.0®: A Clearer Picture of Prostate Health

dispatchesWhen a man presents with an elevated prostate-specific antigen (PSA) level, clinicians typically order a biopsy to see whether the man has prostate cancer. But most PSA blood tests return false-positives, often leading to unnecessary biopsies. Recognizing this, Ross E. Schwartzberg, MD, a neuroradiologist in San Diego, opened a prostate-imaging clinic in 2014. At the clinic, direct patient consultations give men a better understanding of their prostate health without invasive needles or probes

MRI Necessity Questioned Following MSK Ultrasound

MRI exams performed after MSK ultrasounds usually find similar results and rarely change clinical management, said presenters at the 2017 American Institute of Ultrasound in Medicine conference. This begs the question: Are the MRIs really needed? Research at the Cleveland Clinic suggests this could be a chance to reduce redundant imaging. “MSK can be a definitive advanced imaging modality without the need for additional diagnostic imaging in most cases,” said Lulu He, DO, one of the presenters and MSK radiology fellow at the Cleveland Clinic.

About Your College

Here are some things you might not know about the ACR.

• ACR was founded during the Annual Meeting of the American Medical Association by 21 radiologists.
• The first assembly and convocation of the College was held in Chicago in 1924.
• Today there are more than 39,000 members. This includes more than 9,000 members-in-training and 6,000 retired members.
• The ACR governing structure is modeled after the U.S. government. The ACR Council — with representation from all 54 chapters, subspecialty societies, and specific membership segments — functions as the legislative arm. The Council represents the membership and its interests. (The Council Steering Commitee consists of a combination of elected and appointed members to act on behalf of the ACR Council when it is not in session.) Then, the ACR Board of Chancellors implements the policies, just as the executive branch of the government would.
• About 2,100 member volunteers work on 250 commissions, committees, and task forces.
• This year we inducted 137 new fellows at the ACR 2017 Convocation

"In the era of ‘big data,’ radiology will continue to lead in mining and mobilizing data — turning dumb data into smart knowledge to be delivered in real time — just-in time — at the point of care." – James H. Thrall, MD, FACR.

Breast Cancer Deaths Still Declining

breast cancer declineMore than a quarter of a million deaths from breast cancer have been averted since 1990, including more than 22,000 in 2014 alone, according to a recent analysis of newly added 2014 data to the National Cancer Institute SEER database. The breast cancer death rate has now fallen 38 percent since 1990, and that downward trend is credited to increased use of mammography screening that was bolstered in the mid-1980s. In 1990, 73.8 women per 100,000 women died of breast cancer. The new SEER data shows that figure has dropped to 45.9 breast cancer deaths per 100,000 women.

FBI Urges Health Care Community to Guard FTP Servers

The FBI has put the health care sector on alert, warning that there has been a spike in the past year in “ransomware” attacks. These incursions threaten to destroy or publicly display patient data found on servers and backup devices. The alert notes that the agency is aware of “criminal actors who are actively targeting FTP servers operating in ‘anonymous’ mode and associated with medical and dental facilities to access protected health information and personally identifiable information in order to intimidate, harass and blackmail business owners.”

Non-Radiologists Ask a Chatbot

In an attempt to provide a tool for non-radiologists in hospital settings, interventional radiologists at the University of California at Los Angeles are using artificial intelligence to offer clinical support via a so-called virtual radiologist. A virtual consultant, or chatbot, can have a conversation with clinicians via text messages to help them choose the best course of action, such as what contrast to use for a particular patient.

"We’re probably going to be forced to change our practice style. Isolation is largely going to go away as payment models change. Physicians of the 21st century face the challenge of coordinating care with teams of experts and support staff." – Jonathan W. Berlin, MD, MBA, FACR.

Medicare Imaging Utilization and Costs Vary More at County Than State Levels

A new study by the Harvey L. Neiman Health Policy Institute® looks at Medicare beneficiary imaging resource consumption in relation to population economic status at the county level. The study, published in the JACR®, found that in the Medicare population, imaging utilization and costs vary greatly at the county level far more than at the state level. “We observed wide (up to 4-fold) variation in Medicare beneficiary imaging utilization and program costs at the state-level and far wider (up to 14-fold) variation at the county-level,” says Andrew B. Rosenkrantz, MD, MPA, lead study author and a Neiman Institute affiliate research fellow. For radiologists, the study shows the importance of understanding their local mix of patients and how patient characteristics might play into their practices’ shift from volume-based to value-based payment models.

Second-Opinion Breast Reads Change Interpretation

Findings that could impact disease management decisions come up nearly 30 percent of the time after a second opinion review of breast images from a different institution, according to a study published in the American Journal of Roentgenology. Researchers were looking at why radiologists at specialized cancer centers are reinterpreting breast imaging exams from other institutions. They found that patients with suspicious findings from imaging performed through community-organized centers that offer screening services, for instance, are often referred to physicians at cancer centers for evaluation. The goal of the study was to evaluate the overall agreement between the second opinion review and the initial report and to assess how an additional interpretation would affect clinical management.

Radiologists Rank Sixth for Salaries

With an average annual compensation of $396,000, radiologists’ salaries come in at number six, behind orthopedic physicians, plastic surgeons, cardiologists, urologists, and otolaryngologists. Family medicine and pediatric physicians took the lowest paying slots in a new Medscape compensation survey.

Here’s What You Missed

The Bulletin website is home to a wealth of content not featured in print. Check out blog posts, extra articles, and multimedia content at acrbulletin.org.

Onboarding for Long-Term Success

Physicians face multiple transitions during training and practice. Read more about how to successfully manage these new environments at bit.ly/LT_Success.

Resident Work-Life Balance

There’s an alarming trend across radiology: physician burnout. Read about declining job satisfaction among radiologists at bit.ly/MD_Burn.

Creating the Ideal Patient Experience

Read a Q&A with a radiation oncologist on how patients are deal with the stress of an ominous diagnosis and radiation therapy at bit.ly/Final_Read.


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