Vol. 6 Issue 1 Page 10A
PET, SPECT or scintigraphy?
An assessment that compares the use of PET, SPECT and scintigraphy found that “all three methods … may be used to evaluate myocardial perfusion noninvasively in most patients who are referred to a cardiac center,” reported Cardiology.
More specifically, the comparison announced by the Agency for Health Care Policy and Research (AHCPR) studied PET using rubidium 82 as the radionuclide; planar thallium 201 scintigraphy; and thallium 201 distributed by SPECT. According to Cardiology, the AHCPR announced that there was, however, a difference in each study’s cost: scintigraphy was estimated to be $700 to $900; SPECT was estimated to be $1,100 to $1,400; and PET was estimated to be $1,100 to $2,800
For further information, call the AHCPR at 800-435-9203 and ask for the Federal Register notice on PET from Aug. 14.
Smokers’ death trend shifts
Lung cancer surpassed coronary heart disease as the leading cause of smoking-related premature death among middle class, white smokers, said the American Cancer Society. The Society compared death rates among participants in two large population studies conducted in the 1960s and 1980s.
Lung cancer death rates increased in the 20-year period nearly six times in women and nearly two times in men, according to the study published in the American Journal of Public Health. While death rates for lung cancer rose sharply, deaths caused by coronary heart disease and stroke decreased for both men and women, said Michael Thun, MD, co-director of analytic epidemiology for the American Cancer Society, and author of the study.
“While the hazards of smoking remain the same, the diseases by which smoking kills have changed. There has been a huge increase in deaths from lung cancer,” said Dr. Thun.
Cardiac rehab services largely ignored by heart patients
Guidelines released by the Agency for Health Care Policy and Research (AHCPR) say cardiac rehabilitation services are widely under-used despite their proven benefits. These services are defined as medically supervised interventions aimed at limiting physical and other damage from heart disease that reduce the risk of death and help patients resume a normal life.
“Less than a third of heart patients participate in cardiac rehabilitation programs even though potentially all of them could benefit from the services,” said Douglas B. Kamerow, MD, MPH, the AHCPR’s director of clinical practice guideline development.
Breast conservation underutilized
Breast conserving surgery followed by radiation therapy is vastly underutilized, concluded experts at a breast cancer summit conducted during the 1995 meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).
“The number of women receiving breast-conserving therapy with radiation is appallingly low–about 30 percent nationwide,” said Jay Harris, MD, of Beth Israel Hospital in Boston. “Even though 75 percent to 80 percent of women with early-stage breast cancer are eligible for breast conserving therapy, only 35 percent to 40 percent of those eligible elect it.”
Those at the summit concluded that survival rates for this treatment are identical to survival rates after mastectomy, however, reasons for existing high rates of mastectomy are not clear. Dr. Harris speculated that physicians may be slow to abandon the techniques they learned during training.
MRI and CT use on the rise
Estimates of total procedure volume for CT and MRI rose between 1993 and 1994, after a decline in 1993, reported the Technology Marketing Group (TMG), Des Plaines, Ill. The statistics resulted from TMG’s annual survey of more than 90 percent of all CT and MRI sites in the United States.
Estimates of total procedure volume for CT climbed from 18.2 million procedures to 19.4 million procedures between the two years. Volume for MRI climbed from 7.8 million to 8.3 million.
“Total procedures are at their highest levels since our study was initiated in 1991,” said John Vanden Brink, a managing partner at TMG. “Given the cost pressures on health care, it appears positive for these technologies that volume growth has resumed. It would indicate that the medical community has given a vote of confidence to the value of these examinations.”
The census survey gathered information from 4,505 CT and 3,312 MRI sites.
Prostate radiotherapy doesn’t cause impotency
The risk of impotency after external beam radiation therapy (EBRT) for early-stage prostate cancer is lower than after nerve-sparing surgery, said a new study released by ASTRO, conducted at the University of Chicago/Michael Reese Hospital Center for Radiation and Cellular Oncology, Chicago.
The study shows there is no significant difference in the prevalence of impotence in men treated with EBRT and those in the normal male population.
Patients treated with EBRT between ages 50 and 69 had slightly lower impotency rates than those in the same age group who had nerve sparing surgery. For patients 70 to 79 years of age, EBRT results in an impotency rate 4.5 times lower than those treated with nerve sparing surgery, the study found.
The study also found that patients with a history of vascular diseases and/or diabetes and those patients who have had surgery to relieve urinary obstruction before radiation treatments are more likely to become impotent after treatment.
The following individuals have announced personal achievements:
• Brian J. Murphy, MD, was named director of musculoskeletal imaging at Boca Raton, Fla.-based International Magnetic Imaging.
• Scott and White Memorial Hospital and Clinic in Temple, Texas, appointed Gill Naul, MD, chairman of the department of radiology.
• Cathy Fickes, RN, MSN/MBA, was appointed chief executive officer of Mission Community Hospital in Panorama City and San Fernando, Calif.
• Debra Somers Copit, MD, was appointed director of the Gershon-Cohen Breast Imaging Clinic at Albert Einstein Medical Center, Philadelphia.
The following facilities offered news items:
• The University of Texas Medical Branch (UTMB) at Galveston, Texas, is becoming the first medical facility in the country to have a dedicated MRI breast scanning unit, it was announced. The unit will be integrated into UTMB’s Breast Imaging Center. In an agreement with Massachusetts-based Advanced Mammography Systems, Inc., UTMB will become the first major medical facility to install the Aurora™ MRI Breast Imaging System for clinical evaluation.
• St. Joseph Hospital, Elgin, Ill., signed an agreement with Fermi National Accelerator Laboratory to provide neutron therapy to cancer patients. St. Joseph Hospital began patient treatments in November.
• InPhyNet Medical Management, Inc., announced its merger with Radiology Associates of Hollywood, Hollywood, Fla. The group will become a wholly-owned subsidiary of InPhyNet. Radiology Associates, a South Florida group of 34 radiologists, generated approximately $17 million of revenue in 1994.
• The American College of Radiology appointed Derace Schaffer, MD, chairman of the Credentials Committee. Dr. Schaffer is chairman of the department of radiology at Genesee Hospital, Rochester, N.Y.
• The American Society for Therapeutic Radiology and Oncology announced the appointment of its new officers. New officers are Jay R. Harris, MD, clinical chief and professor of radiation oncology at the Joint Center for Radiation Therapy at Harvard Medical School, Boston (chairman of the board); Steven A. Leibel, MD, vice chairman and clinical director in the department of radiation oncology at Memorial Sloan-Kettering Cancer Center, New York (president); Richard T. Hoppe, MD, chairman of the department of radiation oncology at Stanford University School of Medicine (president elect); Karen K. Fu, MD, professor of radiation oncology at the University of California-San Francisco Mt. Zion Cancer Center (secretary); and John D. Earle, MD, William H. Donner Professor of Oncology at Mayo Medical School in Rochester, Minn. (treasurer).
• Melanie Privette was appointed director of communications at the American College of Cardiology. She previously served as assistant director of public relations.
• The Technology Marketing Group, Des Plaines, Ill., has received initial sponsorship for the start of a new census survey to gather data from virtually all radiation oncology sites in the United States. The survey will provide site specific information as well as aggregate data on procedure volume, mix and growth for external beam, brachytherapy and radionuclide therapy, installed equipment and buying plans, staffing levels, utilization of radioactive agents and participation in buying groups. The survey is scheduled for completion in the second quarter of 1996. For further information, call TMG at 708-297-1404.
• The meeting “Current Practice of Vascular Ultrasound” is scheduled for Feb. 23 to Feb. 25, to take place in Orlando, Fla. Sponsored by SONIX and Medical Education Resources, the program will emphasize carotid, peripheral and abdominal applications, and will include individual hands-on instruction and live demonstrations using the latest ultrasound equipment. Nineteen Category I CME credits can be earned. Call SONIX for registration information at 914-921-5700.
• Sponsored jointly by the Medical Technology Management Institute (MTMI) and the Medical College of Wisconsin, a two-day symposium called “Operational Issues in Medical Imaging” is scheduled for March 9 and March 10. According to MTMI, the symposium was organized to “provide a forum to discuss the issues faced by medical imaging services and practical implementable solutions.” To register, and for further information, call MTMI at 800-765-6864.