Imaging under Fire: The Redux

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Lisa Fratt, Editor, Health Imaging

Browsing this week’s top stories, I am reminded of one of my favorite past covers from Health Imaging & IT magazine. The headline read "Imaging under Fire." In the last week, two major medical journals—the Journal of the American Medical Association and The Lancet—published studies that can only be described as combustible.

There is an upside—it’s an opportunity for the imaging community to present a unified voice and share the critical contributions of imaging.

The JAMA study reported continued growth in the use of advanced imaging from 1996 to 2010 among HMO enrollees. "I am concerned that physicians have lowered their threshold for advanced imaging so much that it is now used even when they may not believe it is necessary or will really change their management of the patient," wrote Rebecca Smith-Bindman, MD, of the University of California, San Francisco, and colleagues.

A spokesperson for the American College of Radiology countered that imaging utilization has stabilized, and added, “There are still opportunities to ensure appropriate ordering of scans, but the facts that cancer rates have plummeted, life spans have increased and exploratory surgeries have become largely unnecessary as imaging rates increased should not be lost in the discussion.” Look for additional input and analysis from the radiology community in next week’s newsletter.

In The Lancet, researchers linked pediatric head CT with a small increase in the risk of later brain cancer and leukemia. Although the authors put the findings in context, and stressed the low absolute risk of developing cancer after CT imaging, the study has sparked questions from parents and patients, forcing radiology into a defensive position.

Meanwhile, the Society for Imaging Informatics in Medicine and the Society for Nuclear Medicine and Molecular Imaging held their annual meetings in Florida. Researchers at both meetings detailed the promise of imaging.

Consider Alzheimer’s disease. Progress on the diagnostic front, largely due to molecular imaging, has outstripped progress on the therapeutic front. Molecular imaging technology is facilitating clinical trials. It also will enable physicians to diagnose patients before progression to Alzheimer’s, allowing them to intervene as therapies become available. It’s clear that imaging delivers a critical value proposition and will play a key role in containing the costs associated with Alzheimer’s disease, which stand at $150 billion and are projected to triple in the next 20 years.

Finally, a panel of millennial radiologists looked into the crystal ball and showed how radiology can adopt millennial traits and tools to be more responsive to patients and clinicians and drive safer, more cost-effective imaging use. Harnessing their energy and know-how, and coupling it with the voice of experience, will be key to ensuring radiology’s future.

Feel free to share your thoughts on these and other topics in the imaging community. Have a terrific weekend, too.

Lisa Fratt, editor