Dear CT Insider,
Lung cancer screening takes center stage in this issue, following the April 30 meeting of the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) in Baltimore, which considered whether Medicare should pay for CT lung cancer screening.
The question didn't seem like a particularly heavy lift, considering that the U.S. Preventive Services Task Force had offered a strong (grade B) recommendation for screening high-risk individuals just last December. That decision was based on the strength of the landmark National Lung Screening Trial of more than 50,000 patients -- a quarter of whom were in the Medicare population.
But clinicians and other screening advocates were in for disappointment when they found out that the MEDCAC panel -- packed with representatives from payors but not a single radiologist -- seemed to have it out for them. An immediate account of this odd meeting is available here.
Lung cancer expert Dr. Frederic W. Grannis Jr. was in the room, and by his own account he felt puzzled and ultimately outraged by the negative tone and substance of the meeting. In a Second Opinion article, he describes a grim day spent listening to panelists who seemed hell-bent on stopping screening in its tracks.
Have officials from the U.S. Centers for Medicare and Medicaid Services watched the video of the day's proceedings? Was CT lung cancer screening set up to fail before the meeting even convened? Click here for Grannis' article on the meeting he called a "travesty of the scientific process."
Also on the lung cancer circuit, a study presented at the recent American Association for Thoracic Surgery meeting compared CT to chest radiography for monitoring non-small cell lung cancer patients. See the surprising results here.
More efficient CCTA
In cardiac imaging, iterative reconstruction is a win-win for cutting radiation dose and boosting image quality, but other benefits -- for example, the ability to use less contrast -- can also help keep patients safe.
Researchers from China and South Carolina underscored that last benefit in a recent study that combined reduced iodine dose, lower tube voltage, and iterative reconstruction in coronary CT angiography (CCTA). In a cohort of more than 200 patients, they found few downsides to the low-dose technique. Get the details in this issue's Insider Exclusive.
Every once in a while, a great idea comes up that doesn't require much technology at all. That's what happened for researchers who studied women undergoing chest CT. Writing for the American Journal of Roentgenology, they paired the use of automatic exposure control with the simple act of wearing a bra.
Most women are told to take off their bras before getting on the scanning table, but doing so forgoes the opportunity to save a lot of dose, the authors concluded.
Meanwhile, in stroke care, a new CT-equipped ambulance service in Germany is doing what many advocates of rapid response had written off as impossible: faster treatment for ischemic strokes. Are they really scanning patients in the ambulance? Don't miss the story.
This issue of the CT Insider also looks at a challenge facing patients with HIV and diabetes, who must deal with a new burden, as if the old ones weren't enough.
Finally, we invite you to scroll through the links below for more news from the wide world of CT, right here in your CT Digital Community.
