Archive for the ‘Procedures’ Category

June 5, 2013

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July 12, 2012

IHS First in U.S. to Offer Imaging Diagnosis for Alzheimer’s

On Friday,July 6, 2012, Imaging Healthcare Specialists became the first imaging center in San Diego County and among the first in the nation to offer patients PET brain imaging with Amyvid™, the radioactive agent which can detect the presence or absence of amyloid plaques in the brain as part of a diagnostic evaluation to determine if a patient has the pathology of Alzheimer’s disease (AD). Amyvid was FDA approved in April 2012 and released to select imaging centers across the United States by Eli Lilly on June 1, 2012. In accordance with FDA guidelines, Imaging Healthcare Specialists will use the scan only in people who already have cognitive decline and in conjunction with traditional clinical evaluation.

In this new procedure, patients are injected with a short-acting radioactive agent called florbetapir (Amyvid), which binds to amyloid plaques in the brain that are the hallmark of AD. The patient is then scanned with positron emission tomography (PET) which can detect the presence or absence of amyloid plaque.

According to Mark Schechter, MD, a board-certified diagnostic radiologist and Medical Director of PET Imaging at Imaging Healthcare Specialists, the release of Amyvid for use in patients is a major advance in diagnosing Alzheimer’s disease.

“Until now, the diagnosis of Alzheimer’s disease has been made clinically” said Dr. Schechter, “and could only be confirmed at autopsy.” He added, “This test is a diagnostic adjunct to other clinical evaluation methods, such as physical examination, laboratory evaluation, and neuropsychiatric/cognitive testing, and should only be used to confirm an AD diagnosis in the cognitively impaired patient. Although this test cannot detect very low levels of amyloid plaque, a negative test means that the cognitive impairment is likely due to some cause other than AD.”

This news comes following the May announcement by Health and Human Services Secretary Kathleen Sebelius of a national plan to fight Alzheimer’s disease and find effective treatment and prevention methods by 2025. According to the Alzheimer’s Association, 90 percent of what we know about Alzheimer’s has been discovered in the last 15 years.

Jon M. Robins, M.D., CEO of Imaging Healthcare Specialists, emphasized that the organization has a long-standing tradition of being an early adopter of technology.

“We are truly privileged to become the first imaging center in the region to implement the use of Amyvid in patients outside of a clinical research study. We believe that this is an important diagnostic tool that advances the early diagnosis of Alzheimer’s Disease.”

Currently, health insurance does not cover this scan so patients must pay out of pocket.

About five million Americans already have Alzheimer’s disease and the numbers are expected to soar as Baby Boomers age to approximately 15 million. The Alzheimer’s Association says the annual cost of Alzheimer’s to the United States could increase from $200 million in 2012 to more than $1 trillion by 2050.

Imaging Healthcare Specialists (IHS) has 11 offices throughout San Diego and south Riverside Counties, including Temecula, Oceanside, Encinitas, Poway, La Jolla, Chula Vista and San Diego.

January 4, 2012

Birth Defect Detection on KUSI News

Dr. O’Shaughnessy of Imaging Healthcare Specialists was featured on the KUSI morning news to discuss birth defect detection for Birth Defects Prevention Month.

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.”

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 14, 2011

Commitment to Low-Dose CT Scans Help Ensure Patient Safety

Computed Tomography (CT) scanning, and related medical technologies, are towering milestones that have revolutionized the medical profession. Approximately 70 million CT scans are performed each year in the United States. This means that about one in five adults receive a CT scan annually. The scans, which utilize X-rays, result in cross-sectional images of the body which are successfully used to evaluate conditions of the sinus, chest, abdomen, pelvis, central nervous system, and musculoskeletal system. They have eliminated millions of exploratory surgeries and have allowed physicians to make critical diagnoses. CT imaging has become an indispensible tool in the practice of medicine.

The radiologists and technologists at Imaging Healthcare Specialists have modified existing CT exam protocols to dramatically reduce radiation dose based on a patient’s size, weight and age,” said John O. Johnson, M.D., Chief of CT Imaging at Imaging Healthcare Specialists. “Our low dose initiatives have reduced radiation exposure by as much as 90% in select patients. We are proud to be a leader in lowering radiation dose for our patients while maintaining imaging quality for our referring physicians.”

The increased use of CT scans nationwide has resulted in an unavoidable increase in cumulative radiation exposure to patients.  With the rise in radiation exposure, there is a theoretical increased risk of radiation-induced cancers.  “The natural lifetime cancer risk is 40%,” said Dr. Johnson. “Imaging Healthcare Specialists’ commitment to optimizing our CT protocols ensures that our patients receive the least amount of radiation exposure without compromising image quality, thereby reducing cancer risk.”

Imaging Healthcare Specialists has 11 offices throughout San Diego and south Riverside County, including Temecula, Oceanside, Encinitas, Poway, La Jolla, Chula Vista and San Diego.

October 13, 2011

New Research Shows PET Imaging Effective in Predicting Lung Cancer Outcomes

In a recent study out of the Seidman Cancer Center at University Hospitals (UH) Case Medical Center, it was found that Positron Emission Tomography (PET) scans helped a great deal in predicting which inoperable lung cancer tumors needed additional treatments. Not only do PET scans help in identifying lung cancer “hot spots”, but have now been shown to help doctors choose more effective methods for treating such cancer.

You can read more about this study, you can click here.

October 1, 2009

Statement Regarding Radiation Dose in CT Exams

Recent articles in professional journals and the press have raised important concerns about the use of CT and associated radiation dose. Cedars Sinai Hospital in Los Angeles gave patients undergoing CT brain scans some eight to 10 times the radiation they should have received. The hospital admitted its mistake, but apparently it has been going on for 18 months and has impacted at least 200 patients. In response, a number of professional societies formed the Image Gently Alliance to reduce or “child size” the radiation dose when performing CT on children. Noting that one size does not fit all, this concept may be applied to all CT examinations on all patients.

At Imaging Healthcare Specialists, we have taken the Image Gently pledge. Early in their training, our radiologists are taught the concept of ALARA (as low as reasonably achievable) to limit the use of ionizing radiation exposure when imaging patients. There exists a tradeoff, however, between lowering the radiation dose and achieving appropriate image quality which must be carefully balanced.  As the radiation dose is reduced images may appear noisier but not necessarily less diagnostic. It is useful to remember that the average background radiation exposure that people receive in their everyday environment is 3 mSv (milliseiverts) per year.  A CT scan of the abdomen is approximately 6-8 mSv which translates to 2-3 years of background radiation. This is a useful number for patients to be aware of and provides them with a realistic perspective of radiation dose. While growth in the use of CT in recent years has been substantial, this growth is largely appropriate with many lives saved and invasive procedures avoided. While we should not over react to this potential risk, we should take measures to reduce radiation exposure and educate patients and physicians on the risks, benefits and alternatives for various imaging examinations.

Please rest assured that your CT examination at Imaging Healthcare Specialists will be customized to maximize quality and minimize radiation dose. With CT, several factors contribute to radiation dose including tube current (mAs) and peak kilovoltage (kVp). There is a linear relationship between tube current and dose such that a 50% reduction in current results in a 50% reduction in dose. A more dramatic dose reduction can be achieved by lowering the peak kilovoltage as this is related to radiation dose in a non-linear fashion. We use a combination of techniques based on body mass index to tailor each CT examination to reduce the radiation dose to the lowest possible level. When possible, we limit the z-axis or length of coverage and the use of multiphase exams. And finally, we place bismuth breast shields on our female patients to reduce radiation exposure to breast tissue and diminish the risk of induced breast cancer.

At Imaging Healthcare Specialists, we hope to provide you a convenient, high quality experience from start to finish. Please do not hesitate to call our radiologists with any questions or concerns.

Download Statement Regarding Radiation Dose in CT Exams – October, 2009

September 1, 2009

Stereotactic Breast Biopsy – What you should Know

This is a simple and safe procedure performed at various San Diego Imaging locations by our team of breast imaging specialists. Advanced computer imaging technology is used to map the precise location of the area of interest in the breast that was seen on your mammogram.

This technology aids the physician in removing a small section of the suspicious tissue with pinpoint accuracy. The sample is sent to pathologist, a physician specializing in the analysis of tissue samples under a microscope for diagnosis. The entire biopsy should take approximately an hour.