Radiology

A specificity problem with breast MRIs?

BBC: “About 83% of the MRI scans which appeared to detect a tumour were later found to be so-called ‘false positives’.”

Update:
Dr. Crippen calls the report scare-mongering.

The folly of lung cancer screening

Roy Poses: “Flawed research that supports an expensive, high-technology intervention for which millions of people would be eligible appears in a major journal. The intervention is hyped in news articles, and by a grass roots patient advocacy group. Politicians soon jump on the bandwagon. Citing the potential for saving lives, enthusiasts ignore the flaws in the data that started it all. Only much later do we find out that …

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A Nodule Noted in a Chest X-Ray

If I Had – A Nodule Noted in a Chest X-Ray – Dr. Charles Powell, MD, Columbia University Medical Center
classid=’clsid:D27CDB6E-AE6D-11cf-96B8-444553540000′ codebase=’http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=7,0,0,0′ WIDTH=’380′ HEIGHT=’240′ id=’play_continuous_flvs’>Read more…

Demand a CT scan

A deplorable campaign. Currently, there is no data suggesting decreased mortality from lung cancer screening. Asking the public to “demand” a CT scan simply drives up health care costs without a demonstrable survival benefit.

(via Kidney Notes, Nick Genes also comments)

My take: GE and radiology, health reform, MacBook Air

1) There is evidence that the radiology gravy-train at General Electric may be coming to an end.

My take: The explosion of imaging tests is a major reason for skyrocketing health care costs. Companies like GE and physicians enamored with the latest and greatest studies all exacerbate the myth that “more medicine has to be better”. This has to stop. More needs to be done to …

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Motives behind CT screening

Nice op-ed from Jerome Kassirer on those who push lung cancer screening with CT scans:

How do we know whether these screening recommendations are motivated by concern for patients’ welfare or money, or perhaps both? We don’t. But widespread screening for lung cancer and heart disease can be risky and will be expensive. Experience shows that every time we approve a screening procedure, it is used more widely than …

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Teleradiology

Bob Wachter: “The growing teleradiology trend, driven by the fact that the same technology that allows me to read my films without going to the radiology department also allows a radiologist in Banglaore to read a film as easily as a radiologist in Bangor. The Indian radiologist earns one-tenth of what the U.S. radiologist earns. If my experience in visiting Radiology World tends to be of the positive, collegial sort, …

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An abdominal CT scan is equivalent to about 500 chest X-rays

Something to think about before wanting that CT scan. Nice to see mainstream media tout some of the risks of overtesting.

Defensive radiology

Is the threat of lawsuits causing radiologists to by gun-shy in their impressions? Dr. WhiteCoat explains.

Jerked around by radiology

What happens when they get a reading wrong.

Why the unnecessary CT scans?

For starters, not ordering a CT scan is more likely to have negative repercussions for the physician:

The cancer caused by a CT scan doesn’t generally show up for decades “” and there are all sorts of other intervening reasons why a patient would develop cancer “” so no one is too scared of getting sued for ordering a CT scan. Getting sued for not ordering one is …

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Rectal foreign bodies

A look at the literature (with x-ray goodness).

29 chest x-rays, 9 CT scans

All for one patient in one year. No wonder the system is going bankrupt.

Nuclear radiology tests

A reactor in Canada is out of commission, making diagnostic studies like nuclear stress tests impossible to perform.

Should radiologists apologize to patients?

Many don’t after a missed reading, as they don’t have a relationship with the patient:

When the radiologist has performed his or her duties by interpreting the film, to whom is the radiologist professionally related? The patient? Or the physician who ordered the X-ray or other exam? And what if later it is found that the radiologist has made a mistake or missed a critical diagnosis..has, for example, made …

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Inside Terrorism: The X-ray Project

Fascinating exhibit. From the press release:

Inside terrorism is a photography exhibit which uses actual X-rays and CT-scans from the two largest hospitals in Jerusalem to explore the most important social issue of our time: the effects of terrorism on a civilian population.

“Enlargement of Watch in Neck”

"You never want to diagnose a tension pneumothorax by x-ray"

Tachycardia was the tipoff in this 18-year old without apparent trauma.

Mickey Mouse sign

(via Radiology Picture of the Day)

Defensive radiology interpretation?

Dr. Rob gives us an MRI interpretation that is long, but not really helpful. Is the radiologist trying to protect himself from liability?

The epic story of ordering a radiology study

Follow the saga step-by-step.

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