Radiologists writing on KevinMD about imaging: the radiologist shortage behind delayed reads, radiation dose, mammography and the screening argument, whole-body MRI sold as prevention, point-of-care ultrasound, and whether AI replaces the radiologist, argued by radiologists on both sides. Two maintained records draw on this archive: Cancer: what physicians say, in their own words, and Artificial intelligence: what physicians say, in their own words.

President Obama should have had colonoscopy without sedation

Conditions and Diseases
April 19, 2010

by Michael Kirsch, MD

Does anyone out there know why President Obama underwent a virtual  ‘colonscopy’ (VC) instead of a conventional colonoscopy earlier this year?

In my gastroenterology practice, we do not offer colon cancer screening to 48-year-old individuals, unless special risk factors are present. Of course, maintaining the president’s health is in the national interest, so I understand why professional screening guidelines might not apply to him. For …

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President Obama should have had colonoscopy without sedation

Radiology tests, and how to find their price

Conditions and Diseases
March 30, 2010

I am often asked how we get the prices for the radiology imaging tests, such as MRI’s and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this info. But that’s just not the case. Anyone can find out testing prices.

However, over the last year, those of us working at LesliesList.org have gotten more experienced and better at …

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Radiology tests, and how to find their price

Using CT scans to diagnose chest pain in the ER

Physician
March 6, 2010

During residency, there was always a case of misdiagnosed chest pain to discuss in conference.  Incorrectly sending a patient home and missing the diagnosis of cardiac chest pain was an infrequent, but repetitively observed, phenomenon.

So as to tread carefully with words, it is sufficient to say that even now, chest pain triage remains a vexing problem.

Chest pain diagnosis is like appendicitis; there are always small numbers of unusual cases in …

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Using CT scans to diagnose chest pain in the ER

Why The Biggest Loser uses CT scans to help contestants lose weight

Conditions and Diseases
February 15, 2010

Originally published in MedPage Today

by Cole Petrochko

The train wreck has become an integral part of reality TV programming, and that’s terrible. As much as I’ve learned on the internet about the “Snooki Punch” fiasco from MTV’s Jersey Shore, there’s little to watching a household of adults thrown together under a wacky premise turn into overgrown, throat-seeking children under lights and a camera, except on the one-season CBS show Kid …

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Why The Biggest Loser uses CT scans to help contestants lose weight

Why doctors in the United States order so many CT scans and MRI tests

Conditions and Diseases
January 13, 2010

It’s commonly thought that health care in the United States is heavily dependent on diagnostic testing.

But how do we compare with the rest of the world? Perhaps these graphs, courtesy of the New York Times can provide a stark illustration.

Here’s the data regarding CT scans, showing the number of tests per 1,000 people. Guess which country’s on top:

ct ... <strong srcset=Read more…

Why doctors in the United States order so many CT scans and MRI tests

What’s the most popular way to diagnose a pulmonary embolism?

Conditions and Diseases
January 4, 2010

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Emergency physicians and radiologists overwhelmingly choose computed tomography (CT) imaging to diagnose pulmonary embolism, a potentially deadly blockage of lung arteries, a new study found.

Ninety percent of radiologists and 96% of emergency physicians use CT as their first-line choice for the diagnosis of pulmonary embolism, according to a report …

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What’s the most popular way to diagnose a pulmonary embolism?

Why are women refusing an MRI to screen for breast cancer?

Conditions and Diseases
December 30, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Many women at elevated breast cancer risk may refuse MRI as part of their screening program, largely because of fear and inconvenience, researchers found.

Among eligible women with dense breasts who were at intermediate to high risk for breast cancer, 42.1% refused additional MRI screening as part of a …

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Why are women refusing an MRI to screen for breast cancer?

Radiologists don’t agree with the USPSTF breast cancer mammogram screening guidelines

Conditions and Diseases
December 7, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Radiologists have rejected revised mammography guidelines from the U.S. Preventive Services Task Force (USPSTF), arguing that they are not backed by scientific evidence and will lead to unnecessary deaths.

Under the revised guidelines, “screening will begin too late and its effects will be too little,” said Stephen A. Feig, MD, of …

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Radiologists don’t agree with the USPSTF breast cancer mammogram screening guidelines

Do chest x-rays and mammograms increase the risk of breast cancer in young women?

Conditions and Diseases
December 5, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Some women already at high risk of breast cancer should be cautious about having mammography or chest x-rays before the age of 30 because the imaging may increase the risk of developing the disease, researchers here said.

Five or more x-rays, or any exposure to ionizing radiation before age 20, …

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Do chest x-rays and mammograms increase the risk of breast cancer in young women?

iPhone radiology app to diagnose appendicitis

Health Technology
December 2, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

For years, the pager and cell phone have summoned on-call radiologists to the emergency room. Now this leap in technology: an iPhone App that lets radiologists diagnose a patient remotely, wherever they may be.

Using a $20 iPhone application called OsiriX, radiologists made correct diagnoses of appendicitis in 124 of …

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iPhone radiology app to diagnose appendicitis

When patients receive too much radiation from CT scans by mistake

Conditions and Diseases
October 21, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Reports of stroke patients who were accidentally exposed to eight times the normal radiation dose during diagnostic CT scans at Cedars-Sinai Medical Center in Los Angeles are prompting safety warnings and soul searching among radiologists nationwide.

Over an 18-month period, 206 patients at the center received 3 to 4 …

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When patients receive too much radiation from CT scans by mistake

Radiologists and communicating mammogram results to patients and their doctors

Conditions and Diseases
September 24, 2009

by an anonymous radiologist

I recently read the article and comments on this link from this post, concerning radiologists, from Musings of a Dinosaur.

I was disturbed to discover the animosity with which this topic is covered. The tenor of the blog is that radiologists are greedy, self-serving and are out to erode the doctor-patient relationship. The suggestion that radiologists would schedule percutaneous breast biopsies for their financial enhancement is both …

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Radiologists and communicating mammogram results to patients and their doctors

A routine brain MRI can lead to incidental findings

Conditions and Diseases
September 10, 2009

by Nancy Walsh, Contributing Writer, MedPage Today

Almost 3% of healthy, asymptomatic people who underwent MRI brain scans showed incidental abnormalities in a recent study, leading researchers to express concern about psychological and medical fallout from these increasingly popular screenings.

medpage-todayIn meta-analysis of MRI brain scans, the prevalence of neoplastic incidental findings was 0.70% (95% CI 0.47 to 0.98), while the …

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A routine brain MRI can lead to incidental findings

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eRoentgen for the iPhone puts a radiologist by your side

Conditions and Diseases
September 5, 2009

The following is a sponsored guest post by Constantine Brocoum, a radiologist in Concord, NH. I have personally used eRoentgen, and recommend the product without reservation.

by Constantine Brocoum, MD

Like most inventions, eRoentgen was developed to respond to a need. As a practicing radiologist, I take frequent calls from primary care providers who need assistance in choosing the smartest way to diagnose their patients’ illnesses. They often need help …

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eRoentgen for the iPhone puts a radiologist by your side

Increasing radiation exposure to patients from CT scans and other imaging tests

Conditions and Diseases
August 28, 2009

by Kristina Fiore, Staff Writer, MedPage Today

Imaging procedures can expose patients to high cumulative doses of radiation, researchers say.

medpage-today In a large study, 193.8 people per 1,000 were exposed to moderate doses of radiation each year, while 18.6 per 1,000 were exposed to high doses, and 1.9 per 1,000 received very high doses, according to Reza Fazel, MD, of …

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Increasing radiation exposure to patients from CT scans and other imaging tests

Do patients really need their complete lab and radiology reports?

Conditions and Diseases
August 21, 2009

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

lab-values

Do patients really need their complete lab and radiology reports?

ACR: Reducing medical imaging costs requires a short term investment

Health Policy
July 9, 2009

The following is a guest post from the American College of Radiology.

by James H. Thrall, M.D.

Health care reform cannot be approached with a “one size fits all” cost-cutting mentality. Reducing costs in the long term often requires an investment in the short term — particularly, in regard to medical imaging.

Medical imaging saves lives. Imaging also saves dollars through earlier disease diagnosis, less invasive medical procedures, shorter hospital stays, and …

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ACR: Reducing medical imaging costs requires a short term investment

Nighthawks, dayhawks, and the demise of the American radiologist

Physician
March 29, 2009

More hospitals are resorting to so-called “dayhawk” radiology services to read their x-rays.

It’s modeled after the “nighthawk” model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.

Now, the phenomenon is happening during business hours as well, which according to radiologist Giles W. L. Boland, means that “some radiologists can no longer assume long-term …

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Nighthawks, dayhawks, and the demise of the American radiologist

Why too many CT and MRI scans can hurt patients

Health Policy
December 9, 2008

This is an important article to read.

Many of the incentives today encourage doctors to order more advanced imaging scans, like CTs and MRIs. This expensive practice is invariably caused by this common scenario, as “patients who are in pain often demand scans hoping to find out what is wrong, doctors are tempted to offer scans to those patients, and then, once a scan is done, it …

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Why too many CT and MRI scans can hurt patients

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