A study of the impact of picture archiving and communications systems (PACS) on incidental findings associated with lumbar spinal magnetic resonance imaging, published in the November edition of Radiology, identified an increase in reported incidental findings and recommended follow-up studies.

The study, conducted by physicians from the Department of Radiology at Thomas Jefferson University Hospital, Philadelphia, looked at the results of 2,500 lumbar spinal MRI examinations for each of 5 years: 1 year prior to PACS introduction, 1 year during the transition to PACS, and 3 consecutive years after.

Results showed that the number of incidental findings increased from 19 before PACS to 31 during transition and 53, 49, and 50 after PACS implementation, resulting in a maximum increase of 179%. The most common incidental findings involved potential renal, pelvic, hepatic, pulmonary, and lymph node abnormalities. The total number of recommended follow-up studies increased from five before PACS to 15 during transition and 32, 22, and 18 after PACS implementation, with a maximum increase of as much as 540%. Follow-up expense increased by a mean of 146% after PACS implementation, from $4,221 per 1,000 studies in the pre-PACS year to $9,307, $13,426, $10,558, and $8,252 after that.

Four of the 202 incidental findings represented occult malignancies, which translates to a cost per finding of an estimated $5,721 per diagnosis. The researchers used expected Medicare reimbursement for all follow-up studies to calculate the estimated cost per finding.

All images in the study were obtained at 1.5T, according to the researchers’ standard protocol for lumbar spinal MRI. Also, of the 2,500 reports studied by the research team, 1,512 patients were female and 988 male. The mean age was 52.

The researchers pointed out in the study that it was not designed as a cost analysis study, and direct costs of follow-up examinations were not measured.


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Platinum Equity has announced its intention to merge its two newly acquired diagnostic imaging distributors, Health Care Products division of Royal Philips Electronics and Diagnostic Imaging, to form a single company. The purchases were completed in the weeks leading up to the annual meeting of the Radiological Society of North America. Jerry C. Cirino will become chief executive officer of the new company once the merger is final…. Fjifilm Medical Systems USA Inc, Stamford, Conn, was recognized as Medical Imaging Company of the Year by Frost & Sullivan at that company’s 2002 Excellence in Healthcare banquet. Analysts cited Fujifilm’s ability to leapfrog three spaces in 1 year to capture the number 3 ranking in PACS revenues…Siemens Medical Solutions, Malvern, Pa, also was cited by Frost & Sullivan. The company received both the 2002 Total Solutions Provider of the Year award and the 2002 Hospital Information Systems Vendor of the Year award. In addition, Siemens recently announced the addition of a coding management module to help customers solve business issues associated with coding. The module features a complete home coding solution that enables coders to work from home, the hospital, or any remote location…MDS Nordion, Ottawa, announced that a restart of low-power commissioning of its MAPLE 1 reactor in Chalk River, near Ottawa, has been authorized by the Canadian Nuclear Safety Commission. The reactor is one of a pair that, when fully operational, will be capable of supplying more than 100% of the world’s demand for the key isotopes used in diagnostic and therapeutic medical applications…Eastman Kodak Company, Rochester, NY, has filed a lawsuit claiming that Agfa-Gevaert NV, Mortsel, Belgium, is infringing on Kodak patents related to specific medical x-ray film technologies. The complaint, filed in US District Court in Rochester, claims that Agfa is infringing Kodak patents by making and selling a range of medical x-ray films that employ features covered in Kodak patents for T-grain emulsion technology and for a special crossover-reduction layer in chest x-ray films…DMS Imaging Inc, Fargo, ND, has purchased the assets and operations of Mobile Diagnostic Services Inc, Fall River, Wis. The new company will operate as DMS Portable X-Ray, a division of DMS Imaging…GE Medical Systems, Milwaukee, has acquired Enhanced Vision Systems Ltd, London, Ontario, Canada, a MicroCT imaging technology company. GE has also entered into a strategic alliance with Advanced Research Technologies Inc (ART), Saint-Laurent, Quebec, Canada, to develop new optical molecular imaging applications…Stentor Inc, San Francisco, a medical informatics company, has announced the beta launch of iSite Enterprise for Microsoft Windows XP Tablet PC Edition…Sectra Imtec, a Sweden-based medical technology company, has signed an agreement with Swedish medical technology company RSA Biomedical Innovations AB. Through the agreement, RSA’s software package for analyzing radiostereometric data, UmRSA?, will be fully integrated into Sectra’s system for handling digital x-ray images.