In the News

Polypectomy May Be Unnecessary

Polypectomy – the surgical removal of polyps by colonoscopy – of small polyps found during CT colonography (CTC) is costly and unnecessary, according to a study performed at the University of Wisconsin School of Medicine and Public Health in Madison. This study was recently reported in the American Journal of Roentgenology.

A decision-analysis model was constructed to represent the clinical and economic consequences of performing three-year colorectal cancer surveillance, immediate colonoscopy with polypectomy, or neither, on patients who have 6-mm to 9-mm polyps found on CTC. The analysis model was accompanied by a hypothetical population of 100,000 60-year-old adults with 6-mm to 9-mm polyps detected at CTC screening.

Results showed that, “by excluding large polyps and masses, CTC screening can place a patient in a very low risk category, making colonoscopy for small polyps probably not warranted,” says Perry J. Pickhardt, MD, associate professor of abdominal imaging and lead author of the study.

“Approximately 10,000 colonoscopy referrals would be needed for each theoretical cancer death prevented, at a cost of nearly $400,000 per life-year gained. We would also expect an additional 10 perforations and probably one death related to these extra colonoscopies. There may be no net gain in terms of lives – just extra costs.”

Pickhardt adds, “The clinical management of small polyps detected at colorectal cancer screening has provoked controversy between radiologists and gastroenterologists. Patients should be allowed to have the choice between immediate colonoscopy and imaging surveillance for one or two isolated small polyps detected at colorectal cancer screening.”

The American Cancer Society now recommends CTC for colorectal cancer screening. “If patients with small polyps are monitored, only 5 percent of adults undergoing CTC screening will need to undergo immediate invasive colonoscopy,” Pickhardt says.

— American Roentgen Ray Society





Cone-Beam CT and Percutaneous Vertebroplasty

Cone-beam CT, which is believed to deliver less radiation than multidetector CT (MDCT), is just as useful when evaluating patients before and after percutaneous vertebroplasty, according to a study performed at the department of clinical radiology, Kyushu University, Fukoka, Japan.

Percutaneous vertebroplasty is a minimally invasive cement augmentation technique to relieve back pain that is nonresponsive to conservative treatment. Common throughout the United States and European countries, it is often used when conservative treatments, such as pain medication, activity limitation, physical therapy, and bracing, are insufficient.

The study included 22 patients who had osteoporotic-compression fractures and underwent percutaneous vertebroplasty for treatment. During the study, cone-beam CT and MDCT were performed on all patients before and after percutaneous vertebroplasty.

Before vertebroplasty, all 75 cortical defects seen on MDCT were also observed on cone-beam CT with 100-percent sensitivity and specificity. After vertebroplasty, MDCT found cement leakages in 17 disc spaces, 15 paravertebral soft tissues, and 12 veins; cone-beam CT identified all cement leakages.

“While there is no gross difference between MDCT and cone-beam CT, cone-beam CT is believed to deliver less radiation,” says Akio Hiwatashi, MD, lead author of the study, which appeared in a recent issue of American Journal of Roentgenology.

“Patients can be safely evaluated before and after vertebroplasty using the cone-beam CT system. It is a technical advance in image-guided intervention,” says Hiwatashi.

— American Roentgen Ray Society





Business Briefs

Piedmont Hospital in Atlanta is installing the Aquilion® ONE from Tustin, Calif.-based Toshiba America Medical Systems Inc., to reduce the time for diagnosing symptoms associated with heart conditions or stroke.

Mortsel, Belgium-based Agfa HealthCare has announced that the Lee Memorial Health System (LMHS), in Cape Coral, Fla., has chosen Agfa HealthCare’s IMPAX® PACS for its radiology department. LMHS performs around 680,000 radiology and cardiology exams per year.

Konica Minolta Medical Imaging USA, of Wayne, N.J., has announced that Lewistown Hospital, in Lewistown, Pa., has gone live with the company’s latest CR and DR technology. The multiunit, multisite contract for the main hospital and three outpatient imaging clinics includes: a Regius 370 DR, an upright digital radiography system; two Xpress CR systems; four Regius Nano CR systems; the Drypro 832 laser imager; and the Drypro 793 laser imager.

Carestream Health, of Rochester, N.Y., has announced that Springfield Clinic of Springfield, Ill., has ordered two Kodak Directview DR 7500 systems and two Kodak Directview CR 975/825 systems for its Sixth Street imaging center, which performs more than 15,000 X-ray exams annually.

St. Petersburg, Fla.-based Thinking Systems Corp. has announced that it has installed its ThinkingPACS™ system at the Radiology Institute Imaging Center in Puerto Rico.

Waukesha, Wis.-based GE Healthcare has awarded Amber Diagnostics, of Orlando, Fla., a dealership for its affiliate location, Amber Diagnostics Africa, in Douala, Cameroon. Upon receipt of the distributorship, Amber Diagnostics Africa secured a $16 million contract to provide new GE Healthcare diagnostic equipment to several provincial hospitals in Cameroon.

Aurora Imaging Technology Inc., of North Andover, Mass., has announced that the Aurora® 1.5 Tesla Dedicated Breast MRI System has been installed and is available to patients of Loma Linda University Medical Center, in Loma Linda, Calif.

N. Billerica, Mass.-based Lantheus Medical Imaging has announced that it has been awarded a three-year, sole-source supplier contract by Premier Purchasing Partners LP, the group purchasing unit of San Diego-based Premier Inc.

Varian Medical Systems, of Palo Alto, Calif., is announcing the 1,000th installation of its On-Board Imager® image-guidance system for targeted radiotherapy at Kantonsspital in Lucerne, Switzerland.