What Can the ACR’s Health Policy Institute Do For You? | Diagnostic Imaging

 

How Legislation Will Affect Radiology Technology Use | Diagnostic Imaging

Stop asking radiologists to rule out disease

Stop asking radiologists to rule out disease

When you get frustrated with my interpreting a chest x-ray as “atelectasis at the right lung base, pneumonia can’t be excluded,” trust me, I don’t enjoy it. But when you ask me to rule out pneumonia you leave me no choice but to tell you that pneumonia can’t be ruled out.

To rule out a disease a test must have a sensitivity of 100%, meaning there should be no false negatives. No imaging modality has a perfect sensitivity but the chest x-ray is nowhere near that perfection.

There are often blobs at the bottom of the lungs on a radiograph. In the vast majority these are areas of atelectasis, closure of parts of the lungs. Nearly all patients admitted in hospital have atelectasis. Here is the problem: it looks just like pneumonia. If I call one pneumonia I must call all pneumonia. This would mean that some patient somewhere is going to be put on Imipenem unnecessarily, develop pseudomembranous colitis all because of my interpretation. To reduce that possibility, I throw the ball back in your court by asking you to clinically correlate.

This is not good medicine. We can do better. You can tell me what you are actually thinking and I can tell you what I am actually seeing. Because when you tell me you really suspect pneumonia and I see that blob at the lung base, I will call it pneumonia, because I trust your clinical acumen.

When you don’t really think your patient has pneumonia, but just want to be extra sure because the patient’s temperature has marginally straddled beyond a threshold, and you want to feel you’ve done something by ordering a chest x-ray, be honest. Again, I trust your clinical judgment. I will call that patch atelectasis and won’t disclaim.

Better still, don’t order the test. Yes, you heard that right, don’t order a chest radiograph when you don’t really think the patient has pneumonia: fewer chances of a false positive. This would also mean that whenever you do order a chest x-ray or a CT scan a bulb will light in my frontal cortex, because I trust your clinical reasoning, and I know you are not the type to order tests frivolously.

But when you cry wolf, well you’ve heard the fable. But it won’t be you or I that will suffer, but the patient.

I am in the business of ruling in disease not ruling out disease. I am an adjunct to your clinical reasoning, not a substitute for it. I should mostly confirm your clinical suspicions, occasionally challenge them.

I am only as smart as the appropriateness of your imaging request. A diagnostic test is only as good as you make it. If you ask me to “rule out pulmonary embolism and aortic dissection, and whilst you are can you make sure he doesn’t have bowel ischemia and arterial clot,” my interpretation will read as if transcribed by a decerebrate pigeon. This is because I don’t know what you are thinking or not thinking. I have to assume the worst. My sensitivity rises, and specificity falls, and false positives abound.

Imaging findings are not binary: they are seldom all or none. They are a spectrum. There are shades of gray. Some of those shades are shared by both normal and diseased individuals. If I am forced to rule out disease I will either give lots of normal people disease or have to disclaim.

Help me help you by telling me truthfully your clinical reasoning. United we can be cleverer than Sherlock. By being divided and second guessing each other, we will lead to waste, over testing and poorer quality care.

Saurabh Jha is a radiologist.

What Referring Physicians Want from Radiologists | Diagnostic Imaging

 

Radiologists must engage with Choosing Wisely initiative

Radiologists must engage with Choosing Wisely initiative

By Kate Madden Yee, AuntMinnie.com staff writer

December 19, 2013

Dr. Vijay Rao

Dr. Vijay Rao.

The ABIM Foundation announced the Choosing Wisely initiative in April 2012, with the goal of curbing the use of tests or procedures that are considered overused and/or unnecessary. Nine medical organizations, including the American College of Radiology (ACR), signed on as charter members, and each selected five tests it felt were overused.

More than a year later, the list of member organizations has grown, said presenter Dr. Vijay Rao of Thomas Jefferson University.

“When we conducted our research in March, the ACR and 26 other national medical societies had joined,” she said.

By studying the Choosing Wisely website and other materials, Rao and colleagues tallied how many of the 135 tests listed as overused or unnecessary related to imaging. The group then categorized the exams by body system and modality.

Twenty-one of the 26 nonradiology societies chose at least one imaging exam for its list of overused procedures, and of the 135 tests/procedures listed, 61 were related to imaging (45%), Rao said. Because there was some redundancy among the various societies, Rao and colleagues eliminated duplicates, leaving a total of 49 separate imaging tests identified as overused or unnecessary.

Six of these were echocardiography exams, which are rarely performed by radiologists, leaving 43 imaging tests commonly performed by radiologists, according to Rao.

Choosing Wisely imaging tests by body system and modality
Body system No. of imaging tests Modality No. of imaging tests
Cardiac 11 CT 16
Head and neck 10 Nuclear medicine, including PET 11
Pediatric 5 Ultrasound 8
Musculoskeletal 4 X-ray 4
Abdomen/pelvis 4 MRI 3
Vascular 4 Any imaging at all 1
Chest 2
Breast 2
Whole body 1

Rao listed some examples of imaging tests that Choosing Wisely member societies said should not be performed:

  • Annual stress imaging after coronary revascularization
  • Coronary CT angiography in high-risk emergency department patients presenting with acute chest pain
  • Brain CT or MRI in children with simple febrile seizures
  • Carotid artery imaging for simple syncope without neurologic symptoms
  • CT of the head or brain for sudden hearing loss
  • MRI of peripheral joints to monitor inflammatory arthritis
  • Echocardiography for preoperative assessment in patients without cardiac history or symptoms
  • Routine bone scans in patients with low-risk prostate cancer
  • Predischarge echocardiography after cardiac valve replacement surgery
  • Re-imaging of deep vein thrombosis in the absence of a clinical change
  • Stress echocardiography to assess cardiovascular risk in patients without symptoms and with low risk for coronary disease

As of November, 10 more societies had joined Choosing Wisely, bringing the membership list to 37. And five of these 10 new members had suggested imaging-related tests or procedures, boosting the number of unnecessary or overused exams to 48, according to Rao.

Most radiologists are still unfamiliar with the initiative, and that has to change, she told session attendees.

“As the recognized stewards of imaging during a time when great effort is being made to reduce costs, radiologists need to engage with this initiative,” she said. “We need to become familiar with the list of studies that are perceived to be overused, and then either refute the allegations of overuse or take steps to limit their use.”


Copyright © 2013 AuntMinnie.com

Last Updated bc 12/19/2013 9:48:33 AM

DOTmed.com – Congress backs policy aimed to cut down on unnecessary imaging tests

Cynthia Moran

Congress backs policy aimed to cut down on unnecessary imaging tests

by Loren Bonner, DOTmed News Online Editor
permanent fix to the unpopular sustainable growth rate formula or “doc fix” is making its way through Congress and physicians might be surprised to find out that a provision tucked away in the proposed law would require them to consult “appropriateness criteria” when referring Medicare patients for advanced imaging tests.

The policy, which the American College of Radiology helped lead, is essentially a decision-support tool that will be used by physicians and overseen by the Centers for Medicare and Medicaid Services and the secretary of Health and Human Services.

“Most providers will consult this and it will guide them,” Cynthia Moran, assistant executive director of government relations at ACR, told DOTmed News.

The appropriateness criteria, which is evidence-based, will be embedded in an electronic health record and will notify the provider automatically if the ordering test is appropriate or not. Providers can log onto a secure page on CMS’ website to consult the criteria as well. This feedback will also be compiled and used to evaluate the ordering habits of doctors. By 2020, “outlying” doctors will be subject to prior authorization when ordering tests for their patients. The treating physicians will have to make sure the information follows the patient to the imaging exam and they will also be responsible for submitting the information that the test conforms to the appropriateness criteria in order to get reimbursed by Medicare.

Moran said that the ACR has been working on this approach since the Affordable Care Actlegislation was debated. The policy was not well formulated then, so it only received mention in a clause of the law pertaining to an area of development for the newly formed CMS Innovation Center to consider.

For the past two years, the ACR has been working to get all physician groups as well as vendors to support the policy, not fight it.

“It’s been our highest legislative priority,” said Moran.

But a recent Wall Street Journal op-ed from Dr. Scott Gottlieb from the American Enterprise Institute gives a different representation of the physician-developed appropriateness criteria.

Gottlieb writes: “Radiologists (and other medical specialists) struck a bargain with legislators to give them input into the development of these criteria — one reason doctor groups have rolled over. They see it as a better alternative to price cuts, or more direct controls over their medical practice. The bill does have language to give these groups a say over the criteria, but a fair reading of the bill shows these are weak and give enormous discretion to the Centers for Medicare and Medicaid Services and “the Secretary of Health and Human Services.”

Either way, ACR and other imaging stakeholders see it as a way to be directly involved with payment reform — which is transitioning from reimbursing providers based on volume to rewarding them for value.

The bipartisan bill, called the Excellence in Diagnostic Imaging Utilization Act of 2013 (H.R. 3705), passed the House Ways and Means and Senate Finance Committees last week and now awaits consideration by the full House of Representatives and Senate in early 2014.

ACR and MITA Come to Defense of Clinical Decision Support – ImagingBiz

ACR and MITA Come to Defense of Clinical Decision Support

The American College of Radiology (ACR) and the Medical Imaging & Technology Alliance (MITA) both issued statements underlining their support for clinical decision support (CDS) in advanced imaging following a op-ed by American Enterprise Institute fellow Scott Gottleib, MD.

Dr. Gottleib wrote in both the Wall Street Journal and in Forbes magazine that while the idea behind CDS is good, the current legislative language implementing CDS for Medicare physicians is not. His beef? The language is not specific enough to ensure the Centers for Medicare and Medicaid Services (CMS) and the secretary for Health and Human Services (HHS) cannot use this provision to dictate to doctors how they should practice medicine.

According to Dr. Gottleib, the legislation as currently written requires Medicare ordering physicians to consult a website with imaging appropriateness guidelines and then submit the guideline to CMS when they order the imaging procedure. “Outlier” ordering physicians who contradict the guidelines more often than their peers will then have to submit their orders for prior authorization starting in 2020.

However, the legislation does not spell out exactly who will be involved in creating the appropriateness guidelines or put strict limits on what tests and procedures this system can be applied to, and that is a big problem, according to Dr. Gottleib.

“Federal agencies take vast discretion to interpret and reinterpret the rules,” he warned in Forbes magazine. “Unless they are tightly bound by legislative text, don’t expect them to follow the spirit of the law, or the best of intentions. Agencies march to their own agendas.”

But MITA’s Executive Director, Gail Rodriguez, noted in a statement that Dr. Gottleib’s article was inaccurate and that changing physician ordering patterns through CDS is a much better alternative than the arbitrary across-the-board cuts and reimbursement restrictions that have been used in the past to attempt to lower what Medicare spends on advanced medical imaging.

“Over the years, Congress and Medicare administrators have tried to enact harmful policies – indiscriminately cutting payments, blocking coverage of new technologies, and erecting bureaucratic barriers to patient care. A thoughtful, evidence-based appropriate use criteria policy is a much better approach to guiding medical imaging utilization,” she noted on MITA’s website. “Appropriate use criteria empower physiciansby providing them with the latest information to help inform the discussion with their patients on what care is best.”

The ACR for its part did not directly reference Dr. Gottleib’s articles, but did issue a strong affirmation of its support for CDS following the articles’ publication.

“The ACR strongly supports the imaging provisions in [the SGR Repeal and Medicare Beneficiary Access Act of 2013]. This approach will help medicine transition from volume-based to quality-based care without affecting access or interfering in the doctor-patient relationship. The legislation represents a landmark step by Congress and a validation of a cornerstone of the College’s Imaging 3.0 initiative that increases quality of care and preserves health care resources,” stated Paul Ellenbogen, MD, FACR, chair of the American College of Radiology Board of Chancellors in a message emailed to the media.

A solution for patients who request unnecessary care

A solution for patients who request unnecessary care

As an advocate of patient-centered care, I have to recognize that some varieties of patient-centrism make me more comfortable than others. If I really want the patient to do X, and the patient doesn’t want to, I generally feel okay about that. Frustrated, sure, and often times convinced that my way is the right way and the patient’s way is some sort of detour.

Most often, though, I am able to put aside those feelings and encourage the patient to make their own decision. I am a less-is-more kind of guy, after all. Plus, encouraging the patient’s decision making can leave behind the pleasing glow of low-grade self-righteousness.

But sometimes things go the other way. You have garden-variety back pain, I tell Ms. X, without any alarm signs that might indicate infection or cancer. Yet she still wants the scan. Or say you come to me and want to check your “basic labs,” to make sure “everything is okay with your blood.”

Neither of these is necessary. MRIs for garden-variety back pain can lead to real harm, as can blood tests for no good reason. And this, the asking for things that I don’t think have a point, is very difficult for me to deal with. I think this because it goes against the grain of my personality (I would rather do less, and avoid iatrogenic harm, than do more and cause it) and such requests reinforce a real, justified expectation that we all have when we go the doctor: we should leave with something, even if it is just a prescription slip. It’s as if the x-ray order or the antibiotic we leave the doctor’s office with is an objective correlative for the care they are supposed to give us.

When the patient asks for something that might harm them without discernible use to me, I try to explain my views — and then people, being who they are, sometimes want to make that same decision. Which leaves me with a range of unpalatable options. I can say no; I can say yes; or I can temporize. Saying no makes me feel good and dissatisfies the patient. Often, if the contraindicated care is provided by a broad range of providers anyway (e.g., antibiotics for viral upper respiratory infections), my refusal does no good. If I say yes I have implicated myself in the patient’s potential self-harm.

Part of a solution, apart from me biting the bullet and saying no more often, is to change expectation, so that leaving the visit “with something in hand” can be not just a script, or a procedure, but a plan of action or a symptom diary to be filled out. Until then, disagreement will still get my hackles up, especially if the patient wants something I don’t.

Zackary Berger is a faculty member of the Johns Hopkins University School of Medicine, where he is an internist and researcher in general internal medicine.  He blogs at his self-titled site, Zackary Sholem Berger, and is the author of Talking to Your Doctor: A Patient’s Guide to Communication in the Exam Room and Beyond.

ACR in 2014: 5 Hot Topics | Diagnostic Imaging

ACR in 2014: 5 Hot Topics

CHICAGO — What are the five major areas of concern for radiologists in 2014? Representatives from the ACR detailed at RSNA 2013 several hot topics for the organization, as well as the ACR’s efforts to meet and guide its members through the challenges ahead.

Quality and safety

For the ACR, quality and safety efforts have focused on two main areas in 2013, said Paul Ellenbogen, MD, chair of the ACR Board of Chancellors. And the goal is roughly the same: helping providers and referring physicians better understand how to use imaging modalities.

In 2011, the ACR launched its Dose Index Registry (DIR), a national database into which practices can send information about the dose rates they use with patients. Information is sent to the DIR through software installed either in the scanner or PACS. Practices receive periodic reports that allow them to compare their dose rates to other practices, helping them identify rates that are either too high or too low.

As of March 13, Ellenbogen said, more than 650 facilities participate worldwide in the DIR, 338 of which are fully active. The database houses information on 3.5 million exams and 7.5 million scans. As of the RSNA meeting, he said, the numbers are likely twice as big.

To date, the DIR has mainly collected data on CT scans, he said, because 25 percent of the radiation dose most people are exposed to comes from CT. Efforts are underway now to include computed and digital radiography, as well as fluoroscopy.

The ACR has also actively supported the use of clinical decision support tools that help referring physicians identify the most appropriate imaging study for each patient situation.

“We believe that decision support is an important initiative that we need to ensure the imaging we do is appropriate and necessary, getting us away from exams that havPaul H. Ellenbogen, MD, FACR e no benefit or value,” Ellenbogen said. “The ACR thinks that, in some ways, radiology benefit management groups have not done a good job and that decision support will be the better way to go.”

There are many clinical decision support products available, including ACR Select, he said. The free, web-based product, like other such products, alerts referring physician when they’ve ordered an inappropriate study. It does not, however, prevent the physician from overriding this red flag. In those cases, many clinical decision support products require the referring physician to include a reason for the override.

“We are working with the government to indicate our support for some sort of clinical decision support,” Ellenbogen said. “We aren’t mandating you use ACR Select, but we are trying to mandate that you use some type of decision support.”

Advocacy and Imaging 3.0

In the face of continued reimbursement cuts and the growing emphasis on primary care, radiology and its practitioners must increase advocacy efforts that highlight the value and importance of imaging services, said Bibb Allen, MD, vice chair of the ACR Board of Chancellors.

“In effect, radiology has a presence problem. The public may not realize we’re physicians, and other physicians perceive that radiologists are underworked and unavailable,” he said. “Hospital administrators often view radiologists as competitors, and policymakers only hear about our reimbursement issues. We must prove our relevance.”

To reach this goal, the ACR launched its Imaging 3.0 initiative. This effort, Bibb said, will help radiologists transition from clinician into imaging consultant for referring providers, show providers how to integrate themselves into more facility-wide activities, and will teach them to more actively include patients in the care process.

Bibb Allen, MD“It will take a cultural transition to encourage radiologists to own all aspects of imaging care — to provide better, not just more care,” he said. “We must deliver every bit of imaging care that is beneficial, necessary, and best and not deliver what isn’t essential.”

Mastering this shift is critical as the healthcare system moves away from fee-for-service toward value-based care. It’s no longer enough, he said, to use radiology’s tools — PACS, RIS, speech recognition, etc. — to maximize productivity. Providers must now think about delivering care in the most efficient ways.

And, as radiologists become more comfortable with this initiative, Bibb said, they must add their voices to the chorus already lobbying the U.S. Congress not to cut reimbursement for the critical services radiology provides.

Academics and education

Concern in recent years over whether radiology was training enough residents has given way to worry over whether there will be enough jobs available for new practitioners, said Kimberly Applegate, MD, MS, vice chair for quality and safety in Emory University School of Medicine’s pediatric imaging division.

“At present, there should be a job for all finishing residents, but it may not be in their preferred geographic area, subspecialty, or practice,” she said. “We should be mindful of managing resident expectations and telling them to be thoughtful. They won’t necessarily be able to stay in the area of the country they want to be in.”

According to statistics from the Association of American Medical Colleges, the greatest job growth in the next five years will be in the South and Southwest regions of the United States. There’s also increased demand for several subspecialties, including interventional radiology, as well as general, musculoskeletal, neurological, and breast imaging.

There are also a variety of opportunities for residents and fellows to learn more about the volume-to-value transition, she said. National meetings, including the ACR’s resident and fellows section, will now offer special programming for these groups. In addition, training web modules will also be available through the ACR’s Radiology Leadership Institute.

It’s during these meetings and modules that residents and fellows will learn how to fulfill the growing demand for metrics that show how providers add value to patient care, Applegate said. Practices and providers will now be required to submit this data to CMS, private payers, and certifying bodies, such as The Joint Commission and the Accreditation Council for Graduate Medical Education. The ACR offers guidance on satisfying these metrics in its Imaging 3.0 toolkit.

“Demand for quality and performance metrics will only continue to increase,” she said. “We must take advantage of the opportunities to coordinate and contribute to the evolution of these metrics.”

Economics and government regulation

From the economics and policy angle, radiologists should focus on their payments and what will happen to them in 2014, said Geraldine McGinty, MD, chair of the ACR’s Commission on Economics.

Geraldine McGinty, MD“We are really moving toward a system that looks like we will be paid like the DRG episode of care rather than by fee-for-service,” McGinty said. “That doesn’t mean fee-for-service is going away, but we should still move to optimize what we do on the institutional-service basis.”

The federal government’s focus on expanding reimbursement for primary care services and the pressure on radiology to further manage utilization and control inappropriate imaging are both likely to make recouping sufficient repayment difficult for providers, she said.

Bundled codes — the fusion of codes for two procedures frequently performed together, such as abdominal and pelvic CT — continue to concern the ACR, she said, because it always results in less payment for the provider. Breast biopsy codes are the latest group to undergo bundling.

Still, the ACR has had trouble getting providers to complain about the cuts.

“If we were getting cut by 50 percent, it would be easier to mobilize our community, but the changes have been multifactorial,” she said. “We’re seeing a chipping away at different aspects of payments, and we’ve accumulated significant cuts to what we do. Still, getting a mobilized response has been challenging.”

In addition, despite ACR efforts, CMS still plans to implement the multiple procedure payment reduction (MPPR) that will give providers full payment for the highest reimbursement procedure but only partial payments for other procedures performed on the same patient on the same day.

The 2014 Final Rule from CMS also calls for separate cost centers for CT and MRI with a potential double-digit payment reduction. It isn’t yet clear when this move will be implemented, however, McGinty said.

Radiation Oncology

Although radiation oncology and diagnostic radiology are different specialties, they frequently face some of the same issues. And, recently, for radiation oncology, that issue has been self-referrals, said Albert Blumberg, MD, ACR president and radiation oncology vice chair in the Greater Baltimore Medical Center. The problem is particularly acute in urology for two procedures: intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT).

“Because IMRT and IGRT are so well reimbursed, urologists have realized they have the opportunity — since they control access to the patient — to capture the technical fees for themselves,” Blumberg said. “They’re hiring their own radiation oncologists and are only referring their patients there.”

Recent documentation, he said, revealed that approximately 90 percent of these procedures are self-referred. And, little has been accomplished to stop this problem.

Currently, Maryland is the only state with stringent laws prohibiting self-referrals. Through court action, the state has been able to eliminate instances when they occur. Blumberg recommended radiologists and radiation oncologists reach out to their state societies to express concern about self-referrals and ask that the organization work with the respective legislatures to squelch the practice.

“You might not realize that you have a lot of input in state societies about what happens to you as a physician,” he said. “But, as physicians, we’re all affected by the Board of Physicians, and through input in our state radiological and medical societies, we can have our radiology oncology voices heard.”

– See more at: http://www.diagnosticimaging.com/rsna-2013/acr-2014-5-hot-topics#sthash.rXqD6c6W.dpuf

Reimbursement, imaging appropriateness among top radiology issues in 2013 – FierceMedicalImaging

Reimbursement, imaging appropriateness among top radiology issues in 2013

While the medical imaging industry certainly had its share of stories in 2013 that were intriguing–such as February’s news that radiologists struggled to identify an image of a gorilla purposely dropped into a CT lung scan–four trends stood out as being vital to imaging professionals, as a whole, throughout the course of the year: imaging appropriateness and the use of clinical decision support; reimbursement; CT and its role in lung cancer screening; and the continuing clinical benefits of breast tomosynthesis.

As the end of 2013 fast approaches, I’d like to take a moment to review each of those four trends in some detail.

Imaging appropriateness and CDS

The issue of imaging appropriateness continues to take center stage as a way of reducing unnecessary imaging while saving healthcare dollars and ensuring that patients receive quality care by receiving the right scan at the right time–or no scan at all, if one isn’t necessary.

For example, imaging continues to be well represented in the Choosing Wisely campaign, which is designed to address the problem of patients receiving unnecessary health treatments. Currently, almost half of the Choosing Wisely recommendations concerning tests and procedures are related to imaging.

There also is more evidence that clinical decision support is becoming an important part of the solution to inappropriate imaging. In October, for instance, two Congressional committees issued a draft version of a policy to replace the sustainable growth rate formula that includes language requiring physicians to consult appropriateness criteria for advanced imaging services for Medicare patients. And just this past week, a bill was introduced to Congress that would direct Medicare to require CDS for advanced medical imaging tests performed.

Reimbursement

Another year has passed and yet the specialty continues to experience reimbursement challenges.

Late last month, the Centers for Medicare & Medicaid Services released its final rule for the 2014 Medicare Physician Fee Schedule. According to estimates, the rule will have an overall negative-2 percent impact on radiology services (assuming there is a temporary–or even permanent–fix to the sustainable growth rate formula).

One cut, in particular, was worrisome to breast imagers. In setting relative value unit (RVU) assignments for several new Current Procedural Terminology (CPT) codes for breast biopsy procedures, CMS wants to to reduce physician work values for the new breast biopsy codes by 29 to 54 percent, which would result in significant reimbursement cuts for those procedures. The American College of Radiology is warning that those cuts could reduce women’s access to those services by making it more difficult for providers to offer them.

CT lung cancer screening

In a landmark decision this past summer, the United States Prevention Services Task Force (USPSTF)issued a draft recommendation supporting the use of CT lung cancer screening for long term smokers.

This action comes two years after the primary research results from the National Lung Screening Trial were published, which found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with low-dose helical computed tomography (CT) versus those screened by chest X-ray. What it means is that, like breast and colorectal cancer, CT lung cancer screening likely will become widely accepted and applied.

A number of private insurance carriers already have starting covering this screening exam, and now that the USPSTF has given CT lung screening a B recommendation (which indicated the test provides a moderate/substantial benefit), the road has been paved for Medicare coverage.

Breast Tomosynthesis

Though no longer a new imaging technique, breast tomosynthesis continued to make headlines this past year with the publication of a number of studies demonstrating its clinical benefits.

For example, at the annual meeting of the Radiological Society of North America in Chicago earlier this month, researchers from the Hospital of the University of Pennsylvania presented a study that found that recall rates with tomosynthesis fell from 10.4 percent to 8.8 percent compared to digital mammography, while cancer detection rates increased significantly.

Tomosynthesis is “the most exciting improvement to mammography that I have seen in my career, even more important than the conversion from film-screen mammography to digital mammography,” lead researcher Emily Conant, M.D., said at the meeting. “The coming years will be very exciting, as we see further improvements in this technology.”

Do you agree with my list, or were there other stories or trends that captured your attention in 2013? Let me know in the comments section below, or on social media via FacebookLinkedIn or Twitter. – Mike (@FierceHealthIT)