Edward C. Eichhorn

[email protected]

Practice Management

Flawed MedPAC survey drives debate on imaging payment cuts

As the U.S. debates a sweeping healthcare reform plan in Congress, imaging consultant Ed Eichhorn has discovered what he believes is a serious flaw in the data that federal regulators are using to support an increase in the utilization factor for imaging equipment.

August 10, 2009

2009 06 23 14 37 33 976 Second Opinion Am

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Response Evaluation Criteria in Bone Metastases (RECIBM) and metabolic criteria were used to detect a complete response missed at anatomic assessment. A 76-year-old male patient presented with 1 month of hemoptysis and was diagnosed with small cell lung cancer and bone metastases. Baseline (July 2022) F-18 FDG-PET/CT images (A, maximum intensity projection image; B–E, axial images) demonstrate FDG-avid lesions in the left lamina of the first lumbar vertebra (L1) (straight yellow arrows; maximum standardized uptake value, 2.74; peak standardized uptake value normalized to lean body mass, 1.59) and left ilium (curved yellow arrows; maximum standardized uptake value, 3.68; peak standardized uptake value normalized to lean body mass, 2.28). After seven chemotherapy cycles (December 2022), follow-up PET/CT images (F, maximum intensity projection image; G–J, axial images) show complete metabolic resolution of bony lesions (L1: maximum standardized uptake value, 1.32, and peak standardized uptake value normalized to lean body mass, 0.85; left ilium: maximum standardized uptake value, 1.48, and peak standardized uptake value normalized to lean body mass, 0.82), without apparent osteolytic or osteoblastic changes at CT. Assessment was stable disease (SD) according to the University of Texas MD Anderson Cancer Center (MDA) criteria but complete response (CR) or complete metabolic response (CMR) according to RECIBM, PET Response Criteria in Solid Tumors (PERCIST), and European Organization for Research and Treatment of Cancer (EORTC) criteria. The patient was alive as of September 30, 2025.

New criteria evaluates treatment response in bone metastases

RECIBM-defined response classifications showed high agreement with established criteria and reclassified 19% of patients.

Representative axial noncontrast CT images with and without the hyperdense capsule sign (HDCS). The HDCS is defined as a hyperdense capsule layer of linear shape surrounding a subdural hematoma (SDH). (A–D) Images of SDH with the HDCS (arrowheads). (E–H) Images of SDH without the HDCS.

CT sign may flag who benefits from subdural hematoma procedure

Spine 400

Classification system could improve MRI lumbar spinal stenosis grading

ACR/ASNC highlight changes in proposed 2027 HOPPS rule

Patient Woman Doctor2 400

Gay, trans women less likely to undergo cancer screening

New criteria evaluates treatment response in bone metastases

RECIBM-defined response classifications showed high agreement with established criteria and reclassified 19% of patients.

July 7, 2026

Response Evaluation Criteria in Bone Metastases (RECIBM) and metabolic criteria were used to detect a complete response missed at anatomic assessment. A 76-year-old male patient presented with 1 month of hemoptysis and was diagnosed with small cell lung cancer and bone metastases. Baseline (July 2022) F-18 FDG-PET/CT images (A, maximum intensity projection image; B–E, axial images) demonstrate FDG-avid lesions in the left lamina of the first lumbar vertebra (L1) (straight yellow arrows; maximum standardized uptake value, 2.74; peak standardized uptake value normalized to lean body mass, 1.59) and left ilium (curved yellow arrows; maximum standardized uptake value, 3.68; peak standardized uptake value normalized to lean body mass, 2.28). After seven chemotherapy cycles (December 2022), follow-up PET/CT images (F, maximum intensity projection image; G–J, axial images) show complete metabolic resolution of bony lesions (L1: maximum standardized uptake value, 1.32, and peak standardized uptake value normalized to lean body mass, 0.85; left ilium: maximum standardized uptake value, 1.48, and peak standardized uptake value normalized to lean body mass, 0.82), without apparent osteolytic or osteoblastic changes at CT. Assessment was stable disease (SD) according to the University of Texas MD Anderson Cancer Center (MDA) criteria but complete response (CR) or complete metabolic response (CMR) according to RECIBM, PET Response Criteria in Solid Tumors (PERCIST), and European Organization for Research and Treatment of Cancer (EORTC) criteria. The patient was alive as of September 30, 2025.

CT sign may flag who benefits from subdural hematoma procedure

Among participants with the “the hyperdense capsule sign,” middle meningeal artery embolization resulted in significant benefits over usual care.

July 7, 2026

Representative axial noncontrast CT images with and without the hyperdense capsule sign (HDCS). The HDCS is defined as a hyperdense capsule layer of linear shape surrounding a subdural hematoma (SDH). (A–D) Images of SDH with the HDCS (arrowheads). (E–H) Images of SDH without the HDCS.

Classification system could improve MRI lumbar spinal stenosis grading

By Amerigo Allegretto

An educational intervention that use a classification system led to improved overall correctness and interobserver reliability.

July 6, 2026

ACR/ASNC highlight changes in proposed 2027 HOPPS rule

Released by the Centers for Medicare and Medicaid Services (CMS) on July 2, the proposed rule has a 60-day comment period.

July 6, 2026

Gay, trans women less likely to undergo cancer screening

By Amerigo Allegretto

Trans women are 76% less likely to receive breast cancer screening compared to cisgender women.

July 6, 2026

Patient Woman Doctor2 400

Women's Imaging MinnieCast, Episode 12: Educating the public on breast density

By Amerigo Allegretto

Co-founders of DenseBreast-info.org discuss their work in educating the public on breast density and cancer risk.

July 3, 2026

Minnie Cast Thumbnail (13)

PET/MRI can reduce the need for biopsies in prostate cancer

Prostate biopsies are associated with considerable morbidity, including pain, rectal bleeding, prostatitis, and urinary tract infections.

July 2, 2026

A visual abstract of the study.

Socioeconomic conditions amplify pollution-related bone loss

The findings underscore how environmental and social conditions work together to influence long-term bone health.

July 1, 2026

Adobe Stock 301035832

Medicare Advantage cost-sharing varies for advanced imaging services

By Amerigo Allegretto

More plans require cost-sharing for advanced imaging, with a growing share of plans requiring both coinsurance and a copayment.

July 1, 2026

Insurance Policy 400

SNAP participation boosts cancer screening among food-insecure adults

By Amerigo Allegretto

Food insecurity is tied to people not getting their cancer screening, but SNAP participation may help.

July 1, 2026

Patient Woman Doctor2 400 (1)

PET/CT guides treatment in men with recurrent prostate cancer

F-18 fluciclovine and Ga-68 PSMA-11 PET/CT have similar benefits for sRT planning, in terms of improving cancer control without increased toxicity.

June 30, 2026

F-18 fluciclovine PET/CT images in a 59-year-old man with biochemical recurrence after prostatectomy (prostate-specific antigen level, 0.42 ng/mL; Gleason score, 5 + 4 = 9; T3BN1M0). (A) Coronal PET and (B) maximum intensity projection images show multiple retroperitoneal lymph nodes with abnormal radiotracer uptake (arrows). (C) Axial PET and (D) axial fused PET/CT images show the index lesion (arrow), measuring 13 × 10 mm, on the right precaval lymph node. The initial decision to offer radiation therapy to the prostate bed and pelvis was changed to a decision not to offer radiation therapy.

Most patients want to know if AI being used for imaging reports

By Amerigo Allegretto

Most patients want disclosure about whether AI is being used for their imaging reports.

June 30, 2026

Patient Cancer Doctor 400 (1)

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