Dear CT Insider,
As this Insider goes to press, radiologists and other healthcare providers are on tenterhooks, waiting for the U.S. Centers for Medicare and Medicaid Services (CMS) to push the yes or no button on CT lung cancer screening for seniors. The agency must announce its decision by November 10.
Approval means that Medicare beneficiaries will have the same access to low-dose CT screening as younger folks who meet the criteria for high-risk individuals, while denial means that reimbursement for annual screening will stop abruptly when individuals hit Medicare age.
CMS knows that the vast majority of lung cancers occur in seniors, and more than 70 healthcare organizations and societies, along with dozens of members of Congress, have urged approval of screening for this population. The agency also knows that analyses of the National Lung Screening Trial have found that CT screening in seniors is about as efficacious as it is in younger individuals.
What no one knows is what CMS will do with this knowledge. What you can do is stick to AuntMinnie.com for fast updates when the decision comes down.
While we're on the topic, be sure to read about dueling editorials on lung cancer screening of seniors in a recent edition of JAMA Internal Medicine that continue to churn the waters of expert opinion. Last week, three new studies presented at the Multidisciplinary Symposium in Thoracic Oncology highlighted a lack of knowledge about lung cancer screening among primary care providers, and the high cost of negative biopsies performed outside of controlled screening studies.
The past several years have brought welcome news that CT utilization has fallen in nearly every setting. But it's not the case in emergency departments, where utilization keeps growing, according to a new study in the Journal of the American College of Radiology by Thomas Jefferson University's Dr. David C. Levin. Read the rest of the story in our Insider Exclusive, available to you days before our other members can access it.
After years of new guidelines, protocols, technical innovations, and beefed up organizational support, we like to think radiologists are growing adept at managing radiation risk. But an often overlooked source of guidance is the medical physicist, who has much to offer in terms of ensuring patient safety and great images at the same time. A new practice guideline is forthcoming from the American Association of Physicists in Medicine. Meanwhile, find out what medical physicists really think by clicking here.
There can be little doubt that more CT, not less, is the answer in patients with suspected acute ischemic stroke. The trouble has always been in getting these patients in the gantry before it's too late to administer tissue plasminogen activator to bust clots effectively. But hospitals in Houston, taking a page from a success story in Germany, have launched their own mobile stroke CT ambulance with the aim of starting treatment right away after symptoms occur. And unlike some previous studies, these patients are being followed to find out how they do in the long term. Click here to learn more.
In the coronary arteries, a new contender for predicting the significance of coronary stenosis is making waves. If the results of a new study hold, fractional flow reserve CT may never be the same, not least because radiologists can calculate vessel flow noninvasively on a PC in their own offices. Look here for more.
The long-promised merging of bone-mineral density scans and CT of the abdomen and pelvis seems finally to be getting underway with the approval of software that can analyze existing CT exams without adding a photon of radiation exposure.
As always, stay tuned to your CT Community for the latest news on imaging's powerhouse modality.
