RSNA smorgasbord a delight.
No matter where your place is at the medical imaging table, the 92nd Scientific Assembly and Annual Meeting of the Radiological Society of North America dished up a smorgasbord of fascinating research, educational refresher courses and new technology in Chicago, Nov. 26-Dec. 1, 2006.RAs Take on RSNA
Radiologist assistants may be the new kids on the block, but now they're a definite presence at the largest medical meeting in the world. The 2006 RSNA program introduced a new, all-day educational track for RAs, jointly developed by the ASRT and RSNA.
Sal Martino, Ed.D., R.T.(R), ASRT executive vice president and chief academic officer, welcomed a diverse audience composed of RAs, RA students, radiologists and other interested professionals to the opening session. The inaugural four refresher courses set the stage for continuing education needs of RAs, according to Dr. Martino.
The American Registry of Radiologic Technologists requires registered radiologist assistants to obtain 50 CE credits per biennium. Of those CE activities, a minimum of 70 percent must be in the RA's area of practice, and at least half must be activities designed for physicians or physician extenders. Luckily for RAs, these CE activities also can be used to maintain their R.T. certification.
The RA students in attendance grabbed the opportunity to further their education and to experience all RSNA had to offer. "We were really excited to see the RA track at the meeting. We'd do anything to get to RSNA this year," noted Leslie Ferguson, B.S., R.T.(R), from Bixby, Okla., a second-year student in the Loma Linda University RA program in Southern California.
Ms. Ferguson explained that RA students need a solid background in pathology and disease processes. She hoped that the refresher courses would help her with the highly concentrated RA coursework.
Elizabeth Tinney, R.T.(R)(CT), of Cape May Court House, N.J., and a second-year RA student at Midwestern State University in Wichita Falls, Texas, was happy the large international meeting has recognized RAs. In addition to pursuing RA-specific education, she planned to research interventional equipment with the goal of demonstrating increased knowledge to her radiology practice.
The morning RA refresher courses concentrated on clinical topics such as abdominal and pediatric imaging. Mark Lukens, M.D., an interventional radiologist with High Point Radiological Services in North Carolina, discussed typical signs and presentations of a variety of abdominal conditions, while Denise D. Collins, M.D., the director of pediatric imaging at Henry Ford Hospital in Detroit, described the unique challenges associated with imaging children. Both presentations included a variety of case studies that tested the observational skills of the participants.
Afternoon sessions tackled the functional aspects of RA practice. In discussing RA practice standards and ethics, Joy Renner, M.A., R.T.(R), FAEIRS, of the University of North Carolina at Chapel Hill, emphasized that RAs are held to a higher level of responsibility and accountability. The practice standards are a guide to appropriate practice, but as Ms. Renner noted, the RA profession will evolve over time.
The concern with reimbursement and state licensure was apparent during the question-and-answer portion of the session. Dr. Martino told the audience that the ASRT currently is working with the Centers for Medicare & Medicaid Services to resolve reimbursement issues.
RAs are pursuing different avenues to deal with licensure, depending on their individual situations. Lucina Mallavarapu, M.S., R.R.A., R.T.(R), and her family moved from California to Baltimore so that she could pursue her career as an RA. She proudly displayed her American Radiology Services Inc. business card with the designation "radiologist assistant."
Laura Hallam, B.S.R.T., R.T.(R)(M), a second-year student at Loma Linda, plans to work as an R.T. under that scope of practice until California RA licensure can be resolved. She used the RSNA meeting as an opportunity to network and pass out her resume to interested radiology groups.
The final session covered the use of clinical portfolios to document competence in this age of rapidly changing technology. Kevin Powers, Ed.S., R.T.(R)(M), ASRT director of education, laid out the basic elements of clinical portfolios and the power of capturing data to reflect clinical performance. "If you cannot measure something, you cannot improve it," he emphasized.
Mr. Powers demonstrated an electronic option for recording information about procedures and outcomes. He stressed that it will become more important for RAs to evaluate techniques and procedures in order to make meaningful decisions for their practice.
Education wasn't the only reason RAs and RA students were glad to be at RSNA. Many were sent by their practices to collect information about new technology and assess equipment for efficiency and ease of use. Richard Morreale, R.T.(R), of Beaumont, Texas, and a second-year RA student in the Midwestern State University program, was asked to evaluate 3-D software for his radiology group.
Mr. Morreale also noted that his RA education had an effect on his RSNA experience. "Without a doubt, I see things differently. I now know what the radiologists are looking at," he explained.
Interest in RAs remains high, especially among those radiologists and managers familiar with the concept. Susan Hibbs, M.H.S.A., the director of radiology at Arkansas Children's Hospital in Little Rock, said her facility is planning to "grow" their own RA by sponsoring a student in the RA program at the University of Arkansas for Medical Sciences. Her facility's motivation to hire an RA is the shortage of pediatric radiologists.
But perhaps the significance of the RA presence was best understood by John Larsen, R.R.A., R.T.(R), who also is certified as a radiology practitioner assistant. "I've been attending RSNA for more than 20 years, and I'm super happy about the radiologist assistant track," he said. "I'm glad that radiologists are exposed to who RAs are and what they do."
The Incredible Shrinking Machines
RSNA booths showcased plenty of full-size, multimillion-dollar machines destined for radiology departments of the future. But perhaps the most intriguing equipment on display was the smaller, specialized and mobile units.
Some examples included:
* The CereTom, an eight-slice, portable head and neck CT scanner, was developed by NeuroLogica, in Danvers, Mass. The unit can perform standard CT scans, perfusion and xenon perfusion imaging, and CT angiography.
* TeraRecon, Inc., of San Mateo, Calif., introduced the MGC500, which is a high-resolution, hand-held mini gamma camera. The system was developed for intraoperative and presurgical lymphoscintigraphy.
* The 0.22T MRJ, which is distributed in the United States by EIP, in Wexford, Pa., is targeted to the orthopedic MR market. Used for extremity and shoulder imaging, the unit can be installed in offices with limited space, and the narrow fringe field eliminates the need for elaborate and expensive magnetic shielding.
Most of these systems have been designed for use in emergency rooms, operating rooms, intensive care units, interventional suites or private practice offices. Rather than the patient going to the medical imaging department, the equipment comes to the patient or the point of care. Radiologic technologists need to get ready; in the very near future, they may be practicing in some unconventional settings and with a variety of other health care professionals.
Only at RSNA
First-time RSNA attendees often are overwhelmed by the sheer size of McCormick Place and the quantity of radiology information and products concentrated at a single venue. Yet in the midst of the madness, novices can't help but notice some of the more quirky aspects of the meeting.
1. War of the Floors
Try mopping your floor in the middle of a stampeding herd of 60,000 radiology professionals. The McCormick Place cleaning staff fought a losing battle against scuff marks 10 hours each day.
2. Mr. Wizard Meets MR
Literally every aspect of medical imaging was represented at the meeting. Bernie Wiese, an MR service manager for Air Products of Allentown, Pa., demonstrated the "super cool" effects of liquid nitrogen on hot dogs, a carnation and dishwashing soap. Mr. Wiese used nitrogen for the demonstration instead of the liquid hydrogen normally used to cool MR magnets.
3. Sartorial Splendor
Move over million dollar machines and make way for psychedelic handmade neck ties and scarves with a medical imaging twist at the eBone ties booth.
4 of RSNA's 6,838 Scientific Papers
1 Elasticity Imaging May Reduce the Need for Breast Biopsy
A new ultrasound technique has the potential to accurately distinguish malignant from benign breast lesions and reduce the number of breast biopsies conducted each year in the United States. Elasticity imaging uses software to analyze tissue movement and determine the stiffness of a lesion. Malignant lesions tend to be less elastic and appear larger on an elasticity image compared with a standard ultrasound image.
Richard G. Barr, M.D., Ph.D., and colleagues of Radiology Consultants in Youngstown, Ohio, studied 80 women referred for ultrasound-guided biopsy. The researchers obtained a standard ultrasound image and an elasticity image before the biopsy and measured the lesion on both images. Biopsies confirmed that elasticity imaging correctly identified all 17 malignant lesions in the study group and 105 of 106 benign lesions.
Researchers also found that lymph nodes appear larger on an elasticity image than a standard ultrasound image and demonstrate a dark area; cysts have a characteristic bull's-eye appearance. In addition, the position of the ultrasound probe does not appear to influence the quality of the elasticity image, making the technique less dependent on operator skill.
Dr. Barr suggested that the technique could be modified to evaluate other organs, such as the thyroid. The researchers are planning an international, multicenter trial beginning this month to confirm their results.
2 Pressure-relieving MR Table Pads Reduce Repeat Scans
Patient motion due to discomfort can be a significant problem in MR procedures; therefore, any measure that increases patient comfort also could reduce the need to repeat portions of the exam. Conventional MR table pads can create pressure points in certain areas that force blood flow from those regions, causing pain and soreness.
Chandler H. Park, M.S., and colleagues from the University of Louisville in Kentucky have found that the use of pressure-relieving visco-elastic table pads reduces the number of MR sequences or entire scans that needed to be repeated because of patient movement.
The researchers analyzed the number of repeat MR scans for 100 lumbar MR studies using standard manufacturers' table pads and 100 exams using the viscoelastic pads. Eighteen percent of patients scanned using the standard manufacturers' pads required at least one sequence to be repeated, and 8 percent required the whole procedure to be repeated because of motion.
When a viscoelastic pad was used on the MR table, a significantly smaller number of patients (8 percent) required an MR sequence to be repeated because of movement, and only 4 percent of patients required the entire scan to be repeated.
3 Whole Milk Proves Its Value as a Contrast Agent
Milk may be a viable alternative to oral barium contrast for certain gastro-intestinal CT exams, according to results of a study conducted by Lisa R. Shah-Patel, M.D., at St. Luke's-Roosevelt Hospital in New York.
CT procedures evaluating the small intestine require the use of a negative oral contrast agent, in addition to intravenous contrast, to better define the bowel. Negative contrast agents make the lumen of the intestine appear dark, while the IV contrast makes the intestinal wall appear bright.
However, patients often avoid undergoing a gastrointestinal CT scan because they don't like the chalky taste of barium.
Dr. Shah-Patel and colleagues studied 179 adult patients referred for abdominal or pelvic CT imaging. Overall, they found that milk produced similar bowel distension and enhancement as the barium-based contrast agent VoLumen. In addition, milk was better tolerated by the study group. Forty-two percent of patients receiving VoLumen experienced abdominal discomfort such as cramps, diarrhea and nausea, while only 23 percent of the patients drinking milk reported abdominal discomfort.
Price is another advantage of using milk as a negative contrast agent. VoLumen costs $18 per patient vs. $1.39 per patient for whole milk.
"We hope that substituting milk for other contrast agents will reduce the number of people, especially children, who refuse imaging tests because they do not want to drink oral contrast," said Dr. Shah-Patel.
4 MR Imaging Shows the Power of Branding
Functional MR continues to unlock the mysteries of how our brains work, including why people prefer well-known brand names. According to Christine Born, M.D., at Ludwig-Maximilians University in Munich, typical marketing questionnaires can be subjective and unreliable, but fMR can objectively measure the brain's response to particular brands.
Dr. Born and her colleagues studied fMR images of 20 men and women who were asked to respond to pictures of well-known and lesser-known brands. The researchers evaluated which brain areas became active in response to different stimuli.
Well-known brands activated a network of cortical areas and regions of the brain involved in positive emotional processing. In addition, the study subjects processed the information concerning well-known brands with less effort than lesser-known brands. These results were independent of product group.
The research results complement work in neuroeconomics--a field of study that attempts to better understand the needs and preferences of special target groups.
By Katherine Ott, ASRT Publications Manager
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| Title Annotation: | Radiological Society of North America |
|---|---|
| Author: | Ott, Katherine |
| Publication: | ASRT Scanner |
| Article Type: | Conference news |
| Geographic Code: | 1USA |
| Date: | Jan 1, 2007 |
| Words: | 2217 |
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