Massachusetts Audit Cites 'Unneeded' Imaging

The Massachusetts state auditor reported this week that the state’s Medicaid program, MassHealth, “may be losing millions of dollars due to unnecessary advanced imaging services such as MRIs.”

The audit report cited two main reasons for the “unnecessary” expenditures: a lack of state laws or regulations against self-referrals, and a reimbursement rate that’s higher than the federal Medicare reimbursement rate. You can find the report here and a news release about it here.

A July article in CommonWealth magazine (which covers “politics, ideas & civic life in Massachusetts”) described the state as … read more »

Women of Mexican origin have specific breast cancer-related needs and should be the focus of targeted prevention and education efforts, according to a study at The University of Texas MD Anderson Cancer Center.

The study, published online this week in the journal Cancer, found that:

Among Mexican-origin women with breast cancer who were surveyed, half were diagnosed before age 50. That’s years earlier than the national average for non-Hispanic white women.
Their strongest risk factor was family history, which increased the odds of getting cancer fourfold. Of the women with breast cancer, 85 … read more »

A $5.3 million medical malpractice settlement was reached last week in a case that involved a patient with strokelike symptoms and a dispute over whether MRI results were read.

Michael T. Mertz, an attorney for the patient’s family, said the settlement would be paid on behalf of radiologist Mark Kelly, MD, and his practice, Winfield Radiology Consultants in Winfield, Illinois; neurologist Henry Echiverri, MD, and his practice, NeuroMed Clinic in Warrenville, Illinois; and Central DuPage Hospital in Winfield. The case had been set for trial October 25 in DuPage County Circuit … read more »

Coupling existing MRI equipment with new mathematical methods and high-powered computers, German scientists have created MRI films of moving objects, such as a beating heart or a bending joint.

Researchers at the Max Planck Institute for Biophysical Chemistry in Göttingen, Germany, have cut the time required for recording MRI images to one 50th of a second—20 milliseconds. This should make MRI exams easier and more comfortable for patients (who will no longer need to “hold still”), as well as much more informative and useful for medical personnel. According to an institute … read more »

Fired and then arrested in quick succession last week, a radiologic technologist has been accused of infecting three patients with hepatitis C while stealing drugs during the course of his work at Mayo Clinic in Jacksonville, Florida.

One of the patients, according to the clinic, died at least partly because of the disease.

Mayo administrators said on Wednesday that they had fired an employee who had admitted injecting himself with syringes of the painkiller fentanyl. The drug was intended for patients undergoing invasive procedures at the radiology unit where the employee worked. … read more »

The future of virtual colonoscopy seems … well, let’s just say the images are fuzzy.

Just last month, a study published in The Journal of the National Cancer Institute concluded that computed tomographic colonography (CTC), also known as virtual colonoscopy, was “not cost-effective when reimbursed at the same rate as colonoscopy.”

Now comes an Italian study, published online tomorrow in the World Journal of Gastroenterology, suggesting that CTC should replace colonoscopy as the first option for colorectal cancer screening. “In this setting,” the study concludes, “CTC has clear advantages, such as accuracy, … read more »

A new imaging method using magnetic resonance spectroscopy (MRS) can noninvasively test for and distinguish among different types of degenerative brain disorders, according to researchers at the universities of Minnesota and Washington.

This could have tremendous implications for both neuroscience researchers and clinical neurology. For example, people at risk of carrying the gene for Huntington’s disease, which usually doesn’t cause symptoms until middle age, could elect to be screened before deciding whether to have children. Treatment for a wide range of neurological disorders could begin early enough to delay or ameliorate … read more »

Singer and breast cancer survivor Sheryl Crow has announced the opening of the Sheryl Crow Imaging Center, which she describes as “a state-of-the-art breast imaging center featuring the latest advancements in digital screening and diagnostic imaging technologies.”

Of course it would have the “latest advancements”; after all, it’s in Beverly Hills, California.

Actually, the high-end address is attributable to the fact that it is inside the headquarters location of the Pink Lotus Breast Center, founded by Kristi Funk, MD, who performed Crow’s lumpectomy surgery following the singer’s breast-cancer diagnosis.

In a Tuesday post … read more »

Risk management can be devilishly tricky. For example, is a better breast-cancer imaging method worth the increased radiation dosage for the patient?

A new report in the journal Radiology, being published in the October issue and in advance online today, raises that issue. “A single breast-specific gamma imaging (BSGI) or positron emission mammography (PEM) examination carries a lifetime risk of inducing fatal cancer greater than or comparable to a lifetime of annual screening mammography starting at age 40,” said the study’s author, R. Edward Hendrick, PhD, as quoted in a Radiological … read more »

Just as medical isotopes from the finally restarted nuclear reactor at Chalk River, Ontario, have begun trickling into the supply pipeline, doctors at a national symposium warned of the possible consequences of the current isotope shortage.

Before it was unexpectedly shut down in May 2009, the Chalk River plant had produced up to a third of the world’s medical isotopes—and half of the U.S. supply of the precursor for technetium-99m, used in 80 percent of diagnostic and therapeutic procedures that require isotopes. With repairs of a heavy-water leak completed at last, … read more »

Functional MRI has revealed an odd reason for the typical slowdown in physical response time as we age. And there may be a simple way to counteract the age-related deterioration.

A University of Michigan study says the slowdown results from too much communication between the two halves of the brain, according to a university news release.

During motor activities that involve only one side of the body, a part of the brain called the corpus callosum acts to prevent unwanted cross talk between the two halves of the brain. At other times, … read more »

A new 3-D CT scanning approach may improve treatment for the potentially life-threatening heart disorder ventricular tachycardia. Current ablation treatment for the disorder, which can develop following a heart attack, has a long-term success rate of only 50 to 60 percent.

Researchers at the University of Maryland School of Medicine in Baltimore spent two years testing and customizing software to come up with the new CT technique. It combines images of abnormal cardiac anatomy, blood flow, and heart muscle contraction into a three-dimensional format that can work with existing equipment to … read more »

Starting in January, Medicare patients will be able to receive free mammograms. This provision of the new health-care law also applies to colorectal cancer screening, among other procedures.

This could, reports Michelle Andrews for the Washington Post and Kaiser Health News, significantly increase the number of women seeking routine mammograms. She cites a study published in 2008 in the New England Journal of Medicine. It found that Medicare plans that required copayments of more than $10 had screening rates of 8 percent to 11 percent lower than full-coverage plans.

Currently, patients receiving … read more »

In 2001, the University of Michigan Health System began actively seeking out its own medical errors, fully disclosing such errors to patients, and offering compensation when the health system was at fault.

Since that time, lawsuits and new claims for compensation have decreased, claims are being resolved more quickly, and liability costs have gone down. The findings are detailed in a study published today in the Annals of Internal Medicine.

“The need for full disclosure of harmful medical errors is driven by both ethics and patient-safety concerns,” said lead author Allen Kachalia, … read more »