2008 July

An ongoing trend to consolidate clinical information at the pointof patient care, the need to minimize equipment and system downtime,and growing interest in tracking trends and patterns are a few of thefactors driving the use of digital dashboards in radiology. Productsdesigned for specific roles within the imaging chain are assistingpractices, hospitals and imaging centers with the management of volumeand growth. Meanwhile, further developments are in the works.

As new CAD technologies emerge and hint of increasing clinical confidence and workflow advantages, the granddaddy of CAD applications—mammography CAD—continues to prove its merit in a shifting breast imaging world. The radiology community has accepted Digital Mammographic Interpretation Screening Trial (DMIST) results and looks forward to new imaging solutions like breast tomosynthesis. During the upheaval, one standard has remained steady; CAD remains a mammographer’s good friend.

Advances in breast MR technology and its increased usage thanks to itsrecommended use in some specific patient populations combined withcomputer-aided detection (CAD) are helping radiologists efficientlyreview breast images.

The integration of computer-aided detection (CAD) software into theday-to-day practice of radiology has witnessed the enthusiasticadoption of the applications for some clinical indications. MammographyCAD, which was first greeted with skepticism and suspicion byradiologists, has since enjoyed a groundswell of support. Lung CAD,thanks to diligent efforts by early adopters, is showing signs that itmay be the next area of medicine to embrace widespread utilization ofthis technology.

The stage is set for computer-assisted detection’s next target;colon CAD is poised to make its mark in the next two years. One of theprimary barriers in the U.S. to colon CAD—the lack of reimbursement forscreening CT colonography—is starting to crumble. And several vendors,including iCAD Inc., Medicsight and Siemens Medical Solutions, aredeveloping easy-to-use colon CAD solutions with low false-positiverates.

Supported by a growing base of clinical studies, cardiac CT angiography(CCTA) has shown its utility in improving cardiac patient managementand ruling out heart disease with greater than 99 percent accuracy,while also offering fiscal benefits that can be found by limitingunnecessary diagnostic cardiac catheterization procedures on low- tointermediate-risk patients presenting with acute chest pain.

A good RIS is almost essential to running and managing a radiologybusiness today—with imaging practices and departments often operatingin more than one location and with a premium on everyone’s time, fromreport turn-around to scheduling efficiency.

By distributing the benefits of advanced visualization software toolsto nearly any computer, anywhere, more and more clinicians arebenefiting from thin-client-based advanced imaging techniques. Plus,they can query radiologists live without major workflow interruptions.

A little-noticed provision in the Medicare Modernization Act of 2003could result in the recovery of a sizeable portion of overpayments byMedicare and has healthcare providers concerned that overzealous bountyhunters may come knocking on their door.

While the demand for immediate transmission of digital images is high,and radiologic image compression offers a reduction in data volume, thedebate continues as to whether there is degradation in diagnostic imagequality. With storage prices dropping, many still question whetherimage compression is even necessary.