Radiology

Are MRI results accurate?

Most physicians and patients think that the MRI scan is one of the more sensitive and comprehensive diagnostic tests.

However, there is significant variability in reading and performing the scans, which makes having it done at a reputable institution more imperative:

Magnetic resonance machines, though, vary enormously, and not just in the strength of their magnets. Even more important, radiologists say, is the quality of the imaging …

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Claudia Henschke disgraced

Claudia Henschke is a staunch supporter of CT scans for lung cancer screening. As a radiologist, this is understandable and she stands to benefit financially if CT scans were widely accepted and covered by insurance companies.

Her zealotry has colored her research, as studies in the NEJM and The Oncologist have been called into question. In this editorial in the latter journal (via MedPage Today), an audit …

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Imaging studies

Insurance companies are increasing relying on pre-authorizations to limit imaging studies, which dramatically raises health care costs.

The process claims to be in “real-time”, but in many cases, there a delay that a busy primary care physician can ill-afford. Even waiting 10 minutes to speak with a radiologist pushes the schedule back a whole appointment.

One of the major causes for ill-advised studies is the …

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Colonoscopy turf wars

What if Medicare decides to cover “virtual”, or CT, colonoscopies? Well, it’s going to be ugly.

Colonoscopies are the primary reason why GI physician salaries are so high. They’re going to do all they can to justify continuing to perform endoscopic colonoscopies.

It’s a similar situation with CT-angiograms and the cardiologists.

If physician specialties were stocks, I’d go long in radiology.

Healthy heart scan

A cardiac CT scan for $79? It becomes much more expensive in the many cases of inconclusive results.

It’s easy to profit on the public’s fear of disease and lack of appreciation for false positives. The desire for the quick buck eclipses the concern for the overall cost of health care.

Somehow, I don’t think these entrepreneurs care much.

CT scans

The LA Times (via the WSJ Health Blog) on the downsides of the exploding use of CT scans.

The risk of cancer is discussed, which should give patients pause before undergoing the scan. It’s a good sign that the media is taking a more critical look at overtesting.

Medicare has attempted to limit the number of scans but decreasing payment. However, the results of such …

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Pelvic "x-ray"

I like to visit Street Anatomy periodically for some unique medical imagery.

Here’s a pelvic “plain film” made from magazine clippings (via Hilary Samsa):

Also visit the “Sex After Death” series where you see skeletons having sex. As Vanessa comments: “Who knew you could get that much expression from a skull.”

Indeed.

An early warning on CT scanners and pacemakers

Dr. Wes laments the alarmist warning and the lack of guidance: “The lack of guidance for heart rhythm specialists by the FDA and the Heart Rhythm Society in this regard is stunning and warrants review . . . In short, this seems like a ‘cover your ass’ move by the FDA that threatens to potentially scaremonger our patients.”

Appendicits in pregnancy

(via Radiology Picture of the Day)

Cardiac CT scans

Screw the evidence, according to cardiac CT peddler cardiologist Harvey Hecht: “It’s incumbent on the community to dispense with the need for evidence-based medicine . . . Thousands of people are dying unnecessarily.”

See what Dr. Wes thinks about it.

Marketing cardiac CT scans

Just invoke death.

Radiology tests on Friday the 13th

A bad omen?

Barium . . . or milk?

Milk would be cheaper too:

Researchers at St. Luke’s-Roosevelt Hospital Center in New York randomly assigned 215 patients undergoing abdominal or pelvic CT scans to drink whole milk or a barium beverage . . . Radiologists who didn’t know which drink the patients had swallowed assessed their X-rays. Turns out they couldn’t tell the difference by looking at the images.

(via The Happy Hospitalist)

Cat Scan

(via Street Anatomy)

Functional neuroimaging

Daniel Carlat looks at Spect scams scans and is not impressed:

Most neuromarketers are using these scans as a way of sprinkling glitter over their products, so that customers will be persuaded that the pictures are giving them a deeper understanding of their mind. In fact, imaging technologies are still in their infancy. And while overenthusiastic practitioners may try to leapfrog over the science, real progress, which will take decades, …

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iFluoroscope

Pretty funny. (via Dr. Wes)

Radiology and overtesting

Stark Raving Med: “Some radiologists really want to do the right thing. Some don’t and just want to take your money. But the ones who do continue to produce thoroughly researched excuses for you NOT to order that imaging test. And when you get sued, at least you’ll have the evidence on your side. Of course you’ll still lose, but you can at least take a little solace …

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Abdominal pain, CT scans and Chernobyl

Shadowfax shares a fascinating encounter with a Ukranian family, and their 5-year old with abdominal pain.

Radiology porn

The challenges facing the field of sexual imaging:

Even when you’ve got someone willing to do it in front of an audience and someone else willing to watch, access to the really interesting details remains challenging. Despite all manner of cunning lenses, mirrors and probes, many of the places where genitalia meet other genitalia (and other orifices) have, until recently, remained dark, private and inaccessible.

Claudia Henschke and "blood money"

Roy Poses investigates the controversy surrounding her CT scan for lung cancer screening research.

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