Archive for the ‘In The News’ Category

December 3, 2011

Lung Cancer Awareness on NBC

Imaging Healthcare Specialists’s Dr. Schechter was featured on NBC San Diego News recently to talk with Whitney Southwick about lung cancer and technology used by Imaging Healthcare Specialists to detect it. Watch the video below.

November 18, 2011

Local company increases awareness, lowers radiation exposure on CT scans

The following article, by Jennifer Chung Klam, appeared in the November 17, 2011 Special Health Care issue of The Daily Transcript:

Show up in the emergency room with extreme abdominal pain or a severe headache, and there’s a good chance you’ll get a CT scan.

Computed tomography, or CT scans, provide highly detailed images of internal organs, bones, soft tissue and blood vessels by combining data from multiple X-ray images. Using these scans, physicians can determine whether that stomach pain means you need an appendectomy, or whether that headache is just a sinus blockage or something more serious. CT scans also allow doctors to easily diagnose problems such as cancers, cardiovascular disease, infectious disease, trauma and musculoskeletal disorders.

The scans are quick, painless, noninvasive and accurate, and offer far more detail than regular x-ray exams. As such, the procedure has seen tremendous growth – from 3 million CT scans in 1980 to more than 62 million today.

However, the price of increased clarity is increased exposure to X-ray radiation. Some studies suggest that about 1.5 percent to 2 percent of all cancers in the United States might be caused by the clinical use of CT scans. While most experts agree the benefits of screening for diagnostic purposes generally outweigh the risks, there is growing concern for the increase in radiation exposure associated with the scans.

One local company is trying to minimize exposure by pledging to use the lowest dose possible while maintaining image quality.

“We felt it was important to minimize that risk,” said John O. Johnson, M.D., and chief of CT imaging at Imaging Healthcare Specialists. “We have implemented a program of low-dose radiation for CT imaging so that we can take that small risk to the patient and make it even smaller.”

Imaging Healthcare Specialists (IHS), with 11 centers serving San Diego and Temecula, is the largest provider of outpatient imaging services in San Diego County. It was founded in 2005 through the merger of Radiology Medical Group and Open Air MRI Centers.

In 2007, the Alliance for Radiation Safety in Pediatric Imaging – a coalition founded by the Society for Pediatric Radiology, the American Society of Radiologic Technologists, the American College of Radiology and the American Association of Physicists in Medicine – developed the Image Gently campaign to raise awareness of the need to adjust radiation dose when imaging children.

“We took that as a model and kind of a mantra at Imaging Healthcare Specialists and started looking at ways of lowering the dose” in children as well as adults, Johnson said. “The idea behind the Image Gently campaign is not every CT scan is the same; not every patient is the same size; not every diagnosis is the same. So each CT scan should be customized for each patient.”

For example, if a patient is smaller in size, say a young adult or female, a lower radiation dose should be able to be used without compromising image quality, he said.

Radiologists can get more detailed scans by using more radiation, but doctors always need to weigh the risk against imaging needs. Often, IHS physicians are willing to accept a small erosion in quality to lower the dose, said Johnson.

In addition to reducing dosage based on age, height, weight and body mass index, IHS has invested in the most advanced scanners and noise reduction software, which can reduce exposure by 50 percent. IHS also routinely shields breast and thyroid tissue to further protect sensitive organs.

“The shields in and of themselves can reduce radiation by 40 percent,” Johnson said.

Using a combination of these techniques, IHS has been able to reduce radiation in some patients by as much as 90 percent.

Earlier this year, IHS took the Image Wisely pledge, the adult counterpart to the Image Gently campaign. The program encourages practitioners to avoid unnecessary procedures and to use the lowest optimal radiation dose.

“Our goal is to get the word out, increase awareness, and let more people know that patient safety is a top priority by spreading the word,” Johnson said. “We want to make this a top priority for everybody.”

In the past, doctors were more focused on having perfectly crisp, clear images. There was no perceived problem. Standard protocols for dosing levels were used, and today many institutions still adhere to these one-size-fits-all protocols, according to Johnson.

But awareness of the issue is growing, in part due to a high-profile public health concern in late 2009. It was reported that during an 18-month period, 269 patients at Cedars-Sinai Medical Center in Los Angeles were exposed to radiation at eight times the normal dose.

In the wake of the incident, California passed Senate Bill 1237, which requires hospitals and clinics to record radiation doses of CT scans, and radiation overdoses to be reported to the patient, treating physician and the California Department of Public Health. The law goes into effect July 2012.

In the meantime, IHS has enrolled in the Dose Index Registry (DIR), supported by the American College of Radiology. DIR collects, anonymizes and stores information about CT exams from participating facilities. In the coming years, IHS will be able to establish its own benchmarks and compare its performance with other institutions. Data collected from the registry will also be used to
establish national benchmarks for CT dose indexes.

“We’ve aggressively lowered the dose probably more than anybody in the country,” Johnson said. “Especially for an outpatient, community-based organization, we’ve been very forward thinking and proactive.”

November 14, 2011

Ultra Low-Dose CT Might Not Mean an Equipment Upgrade

The following article was written by Whitney L.J. Howell for diagnosticimaging.com:

Bringing your low-dose CT protocols down even further doesn’t have to mean tossing out your old scanners and buying pricey new ones. According to one San Diego-based imaging center, you can trim radiation doses to almost nothing and still get high-quality scans appropriate for diagnosis.

The key is pairing iterative reconstruction (IR) with other methods that tailor low-dose protocols based on patient weight, said Jon M. Robins, MD, co-chief executive officer for Imaging Healthcare Specialists (IHS). IR technology wipes noise from CT scans, leaving behind an image with clear resolution. Using both strategies together means Robins wasn’t forced to purchase new scanning equipment.

“Our center made a commitment a few years back to offer the lowest dose CT scans we could. We have older scanners in my office – 4-slice, 8-slice, and so on – and I didn’t want to spend the $90,000 to $100,000 on technology with low-dose characteristics built in,” said Robins, who is also IHS’s heart imaging medical director. “IR has allowed us to extend our low-dose efforts to head and neck scans, pelvis, colonoscopy, sinus, and others.”

IHS purchased its IR technology – generic iterative retrospective reconstruction (GIRR) – from a third-party vendor in Israel. According to Robins, it interfaces with older scanners, enabling the machines to produce ultra low-dose images with clarity equal to scans from more modern technologies.

Since implementing IR in August, he said, IHS has achieved a 90 percent dose reduction in nearly 1,500 scans. This drop includes the initial 40 percent reduction IHS produced several years ago by using a patient’s body mass index to tailor each protocol. In addition, Robins said, the practice uses breast shields, includes contrast only when absolutely necessary, and doesn’t delay studies as ways to shave off radiation exposure.

However, Paul Kinahan, PhD, a University of Washington-Seattle radiology professor, said he was skeptical that such a significant dose reduction is possible with older scanners. It’s a claim that requires much clinical testing and evidence-based data, he said.

“This is certainly an area of a lot of interest, and it’s one that many in radiology feel is worth pursuing,” Kinahan said. “But demonstrating a reduction in radiation dose and getting an image of equal diagnosis quality on vintage equipment armed with a third-party product gives me pause.”

In many cases, he said, radiologists dislike the images IR produces, citing the amount of noise that remains. To overcome this issue, many technologists blend IR images with established analytical methods to reach some dose reduction while maintaining image clarity.

Robins agreed the ultimate quality of IR-generated images depends on quality of the image it’s asked to clean. So, before you make any changes to workflow, he recommended you examine every protocol for all your scans to determine what dose will give you both a low-dose, high-quality study.

“I’ve been extraordinarily excited by this technology, and I’ve even given the scans to colleagues to read. They didn’t know it was an ultra low-dose image produced through IR until I told them,” Robins said. “Using this technology has greatly impacted our promise to pursue the lowest-dose CT scans possible. I haven’t been disappointed.”

October 31, 2011

Working to Lower Radiation in CT Scans

The October 31 issue of the San Diego Business Journal features an article interviewing Imaging Healthcare Specialist’s Dr. Jon Robins. In the article Dr. Robins highlights Imaging Healthcare Specialist’s efforts to decrease the amount of radiation that patients are exposed to during CT scans. The article discusses policy as well as the implementation of new radiation lowering tools. You can read the complete article on page 10 at this link:

www.littleurl.net/b52dd2

October 28, 2011

IHS Breast Cancer Awareness on CW 6 News

Imaging Healthcare Specialists’s Dr. Tena was featured on San Diego CW 6 News this month to promote Breast Cancer Awareness. Watch the video below.

October 27, 2011

IHS Low Dose CT explained in La Jolla Village News

Our own Dr. Johnson was featured in the October 27th edition of the La Jolla Villiage News. The article, written by Johnny McDonald, is shown here:

La Jolla specialists have established a CT-imaging program to lower the amount of radiation dosage needed for patients.

“The dramatic reduction of radiation dosage is based a great deal on the patient’s size, weight and age,” said Dr. John O. Johnson, a diagnostic radiologist at Imaging Healthcare Center. “We’re able to adjust the perimeters that control CT (X-ray computed tomography) exam dosage carefully and methodically.”

The center, located in the Regents Medical Plaza at 4150 Regents Park Row, Suite 195, is one of 11 imaging clinics in San Diego County. “We’re much more concerned about the exposure to radiation in youngsters and young adults,” Johnson said. “The reason for that is they are more radio sensitive. Their body cells are more quickly divided and they have a much longer life span.”

He said the exposure has been reduced by as much as 90 percent in select patients.

Statistics indicate the average American’s dose of radiation is six times greater than it was 10 years ago, predominantly due to the increased use in radiography as a diagnostic tool. Johnson said approximately 70 million CT scans are performed each year in the United States — about one in fiveadults. “With the rise in radiation exposure there is a theoretical increased risk of radiation-induced cancers,” he said.

Johnson received his diagnostic radiology residency training at UC, San Diego, where he served as chief resident in radiology. Since joining Radiology Medical Group in 1990, he has held several positions of leadership within the group. He currently sits on several committees within Scripps Health that deal with the selection and implementation of advanced medical imaging technology within the system.

Imaging examinations include MRIs, digital mammograms, lung cancer screening, angiography and osteoporosis evaluations. “CT is revolutionary in that we can diagnose conditions earlier and avoid more invasive, complicated procedures,” he said. “CT scans are lifesaving. Smoking, heavy drinking and environmental exposures are all cancer danger signs.”

We’re a leader in low dosage images and that’s the message we want to give the community,” he said.
Studies show that in the last 100 years, diagnostic radiology, nuclear medicine and radiation therapy have evolved from the original crude practices to advanced techniques that form an essential tool for all branches and specialties of medicine.

August 15, 2011

IHS Listed as one of the Top 25 Connected Healthcare Facilities in the Nation

In the August 2011 edition of Health Imaging & IT, IHS was listed as one of the Top 25 Connected Healthcare Facilities. Here is what they wrote in the article:

Health Imaging & IT’s Top Connected class of 2011 is an illustrious group. Several previous winners have re-appeared and demonstrated their continued commitment to imaging connectivity across the enterprise, reporting ongoing gains in various metrics, such as turn-around time and operating costs. One common theme across our repeat winners? They are leveraging data to inform strategic decisions and monitor results.

It’s a business model to be replicated.

Reading between the lines, there are hints of positive developments. Yes, hospitals, health systems and radiology practices are squeezing every ounce of productivity and innovation from their investments in imaging modalities, informatics systems and staff. Compared with last year, volume is steadier, with most sites showing slight gains.

We considered Health Information Management Systems Society (HIMSS) EMR adoption stages, according to the HIMSS Analytics EMR Adoption Model. Our winners are conglomerated at the top of the scale, with most reporting at stage 6 or 7. That means they fall in the top 4.5 percent of U.S. facilities.   

Read on for short profiles of recent imaging connectivity projects at this year’s Top Connected organizations.

Imaging Healthcare Specialists:
The San Diego imaging center leverages a vendor-neutral, cloud-based, electronic medical information exchange service to make images and reports available via the EMR or email to hospitals, physicians and patients, which has eliminated film and paper and makes results immediately available to referring physicians. Results are frequently available to physicians before patients leave the imaging center.