Breast Biopsy Consensus

Minimally invasive breast biopsy is preferred over the use of open surgical biopsy, according to a panel of 22 cancer specialists, including surgeons, radiologists, and pathologists, and it may save 80% of women with suspected breast cancer from surgical operations. The consensus was discussed in the paper, “Image-Detected Breast Cancer: State-of-the-Art Diagnosis and Treatment,” published in the September issue of the Journal of the American College of Surgeons, and presented at the International Breast Cancer Consensus Conference, sponsored by the Keck School of Medicine, University of Southern California, Los Angeles.

The consensus paper additionally concluded that physicians needed more training in the use of breast ultrasound, and that magnetic resonance imaging may not only diagnose, but even detect, abnormalities among high-risk women. The panel also identified the important role of sentinel node biopsy in diagnostic techniques, and urged the adoption of proper training and education. The panel also called for insurers to better cover mammography screenings. In addition, oncoplastic surgery, the combination of plastic surgery and cancer surgery, was strongly suggested.

“Wider use of currently available techniques will further improve patient selection; reduce breast cancer recurrence, mortality, and morbidity of therapy; improve cosmetic results; and decrease overall costs,” stated Melvin J. Silverstein, MD, professor of surgery at the Keck School and conference chair.

FDG PET Pay Revised

The Centers for Medicare & Medicaid Services (CMS) has announced an increase to $1,375 of its proposed reimbursement rates for positron emission tomography (PET) studies with fluorine 18-labeled deoxyglucose (FDG). CMS originally proposed an FDG PET reimbursement of $841.50 in August 2001, when the published average wholesale price for FDG was $750.

“We were able to show how there were errors in the data on which CMS had originally based its proposed reimbursement, and the agency responded by developing a more reasonable, though still disappointing, reimbursement amount,” states Alan Maurer, MD, president of the Society of Nuclear Medicine (SNM).

The SNM and the American College of Nuclear Physicians (ACNP) remain concerned that the proposed rate, down from the original $2,331.18, may have a negative impact on the expansion of PET services into communities where it does not currently exist because it will be more difficult for hospitals and other facilities to recoup costs associated with the installation and operation of PET centers.

CMS also released, on November 27, 2001, a clarification document that specified the type of technology that can be used to obtain reimbursable PET scans, in response to the outcry that followed that agency’s determination to exclude coverage for PET scans performed on dual-headed gamma cameras.

The following scans are reimbursable if performed on a coincidence system featuring a crystal at least 5/8 inch thick, digital detectors, and iterative reconstruction, and utilizing techniques to minimize or correct for scatter and/or randoms: characterization of single pulmonary nodules; initial staging of non-small cell lung cancer; determining location of colorectal tumors based on rising CEA level; staging or restaging of lymphoma when used as an alternative to a gallium scan; and evaluating recurrence of melanoma prior to surgery as an alternative to a gallium scan.

Book Highlights the IHE

A new publication released in December by the Healthcare Information and Management Systems Society (HIMSS) explores the latest efforts to integrate information technology systems in health care. “Integrating the Healthcare Enterprise,” edited by Paul R. Vegoda, details the fundamentals of the IHE initiative, a project aimed at improving the way computer systems share information within health care organizations.

The book can be purchased on the HIMSS web site,

Industry News

Fujifilm Medical Systems USA, Stamford, Conn, and VitalWorks Inc, Ridgefield, Conn, have entered into an agreement to integrate Fuji’s Synapse? picture archiving and communications systems (PACS) with VitalWorks’ RIS systems, and comarket both systems to the US ambulatory imaging center market…

CADx Medical Systems, Laval, Quebec, Canada, has received US Food and Drug Administration (FDA) approval for its Second Look? computer-aided detection (CAD) system for mammography…InSight Health Services Corp, Newport Beach, Calif, a national diagnostic imaging services provider, has been awarded a California Team Excellence Award (CTEA) and an honorable mention from the California Council for Excellence (CCE), Poway, Calif. Both awards recognize process management, innovation, and problem-solving skills through organized work teams…

GE Medical Systems, Milwaukee, has signed a deal to acquire the digital health record assets of MedicaLogic, Hillsboro, Ore, a provider of electronic medical records (EMR) for patients treated in care areas outside the hospital. The company also has launched a Magnetic Resonance (MR) Safety and Patient Comfort Web site, designed to provide health care providers and patients with access to safety information and scanning tips for a positive scanning experience ….

Instrumentarium Imaging Inc, Milwaukee, has received FDA clearance to distribute the MammoReader?, developed by Intelligent Systems Software Inc (ISSI). The product is a CAD system that assists radiologists in reading mammograms…

The National Cancer Institute has awarded a 2-year, $1.98 million research contract (Contract N01-CM-17004) to Siemens Medical Solutions to develop and evaluate a new research interface that would provide researchers with greater access to the raw data gathered by ultrasound systems. The interface initially will be developed for SONOLINE? Antares. Siemens will partner with Duke University, Durham, NC, and the University of Rochester, NY, to evaluate and polish the final software product.