Tempest in the Reading Room
Breast imagers may have breathed a collective sigh of relief with the publication of three-decade data from the Swedish Two-County Trial in Radiology in July. Tabar et al demonstrated a long-term and sustained mortality benefit associated with screening mammography.

The respite from the debate, however, was all too brief. In July, the British Medical Journal published a study claiming that breast cancer mortality declines are largely due to improved treatment rather than screening mammography.

Stakeholders in the U.S. galvanized quickly and delineated the flaws in the study. Indeed, one of the few upshots to the ongoing mammography storm may be the response of the breast imaging community.

Radiologists are turning to education and advocacy to counter the myth that screening mammography is not effective. By doing so, breast imagers not only provide a valuable service for patients, they also offer a leadership model for their colleagues.

It's a role radiologists need to fill, Pat A. Basu, MD, PhD, White House Fellow told us in his Imaging Insider interview. Basu, and others, have decried the lack of leadership in radiology and even opined that radiologists lack of visibility among other caregiveres threatens to commoditize the profession. Breast imaging leaders like Daniel B. Kopans, MD, and Michael N. Linver, MD, are neither silent nor invisible. Both make salient points in our cover story.

Another mini-tempest seems to be bubbling over in the emergency department with ED physicians heavily criticized for their profligate use of CT. In 2007, one of every seven patients visiting the ED underwent a CT scan. Unlike screening mammography, however, the CT issue may be more hot air than outright storm. A study published in the September issue of Annals of Emergency Medicine suggests a link between the rising use of CT in the ED and reduced admissions or transfers after CT.

Health Imaging & IT peels back the layers to better understand the trends and how radiology can help better target CT in the ED. Hint: think clinical decision support and appropriate use criteria.

Finally, we explore two areas where technology lends a helping hand. Many radiology departments are transitioning to automated contrast injectors, which provide a dual bang for the buck. They improve patient safety and better the bottom line.

Mobile devices are hot, too, but they have not yet carved a niche in imaging. We visited a handful of early adopters to see how they are leveraging iPads and Androids to enhance patient communication and radiology workflow.

Now that summer is drawing to a close, what tempests are you battling (and conquering)? Let us know.

Lisa Fratt | lfratt@trimedmedia.com