Minimally Invasive Treatment of Uterine Fibroids Successful
A multi-center prospective uterine fibroid embolization (UFE) study of 555 Canadian women shows a high efficacy rate, with a low complication rate and rapid recovery, according to the January issue of Fertility and Sterility.
Results of the study, which involved eight Ontario university and community hospitals and was known as the Ontario UFE Trial, revealed that 83% of the women showed symptom improvement, 91% showed patient satisfaction, and less than 2% had major complications as a result of the UFE treatment. Gaylene Pron, PhD, epidemiologist and the study’s primary author, calls the study “significant because of its size and because it shows a high rate of efficacy for a relatively new procedure, even when performed widely in multiple hospitals by a variety of interventional radiologists.”
The study also showed significant differences in onset and treatments for black women, who are more prone to uterine fibroids, one of the most common medical conditions in women ages 35-50. In the study, black women were younger and had experienced symptoms longer. They were also more likely to report pain and bleeding and more likely than white women to have multiple fibroids that would suggest a greater genetic disposition for fibroids.
The main outcome measures were uterine fibroid volume reduction, symptom improvement, improvement in quality of life, and satisfaction with the treatment. At 3-month follow-up, median fibroid volume reduction was 42%. Significant improvements were reported for menorrhagia, or heavy menstrual bleeding (83%), dysmenorrhea, or painful periods (77%), and urinary frequency/urgency (86%).
Two recently published studies address a worrisome phenomenon that continues to show up on radiographs following surgery: retained instruments, such as surgical sponges or other foreign bodies.
An article in the February edition of the American Journal of Roentgenology (AJR) says that the retention of surgical sponges or swabs in the abdomen or pelvis occurs with a frequency of one in 100 to 5,000 operations and accounts for 50% of malpractice claims for retained foreign bodies. Authors of the study recommended routine radiographs following surgery.
In addition, an article in the January 16 edition of the New England Journal of Medicine recommends routine screening x-rays to exclude retained surgical instruments in high-risk? patients. Based on claims and incident reports filed with a major medical malpractice insurer, investigators found several risk factors, including emergencies, unplanned changes in procedure, and higher body mass index (BMI). In a study of 61 foreign bodies retained by 54 patients, 69% were sponges and 31% instruments. Of these 54 patients, 37 required reoperation, 12 had small bowel fistulae, obstruction, or visceral perforation, and one died. In one third of cases, there was no documentation of sponge or instrument count.
First Whole Body PET/CT C-11 Radiopharmaceutical Scan Performed
Researchers at the Hong Kong Sanatorium and Hospital (HKSH) have performed the world’s first whole body PET/CT scan using short half-life C-11 radiopharmaceuticals with a new lutetium oxyorthosilicate scanner.
The doctors conducting the study, David W. Yeung, MD, and Garrett C.L. Ho, MD, both from the HKSH Department of Nuclear Medicine and PET, note that the C-11 radiopharmaceuticals provide a more sensitive cancer tracer for diagnosing liver, renal, and prostate cancer, as well as low-grade lymphoma and low-grade brain tumors. “This greatly complements the use of FDG and improves the sensitivity and specificity in molecular imaging of some FDG non-avid tumors,” reported the doctors.
As of October 2002, the doctors had performed 24 C-11 acetate and two C-11 choline whole body scans. For the first 20 patients, 1-minute emission/bed PET acquisitions were performed with a total whole body PET/CT acquisition time of approximately 9 minutes. The protocol was later modified to a 2-minute emission/bed PET acquisition time for increased image quality. The doctors reported that the total time for a whole body PET/CT scan is about 15 minutes.
CT Facilitates Early Lung Cancer Detection
CT allows radiologists to detect lung cancer in earlier stages than x-ray, but results in a high number of false positives, according to a study that appears in the March issue of Radiology.
The study, led by Stephen J. Swensen, MD, chair of the Department of Radiology at the Mayo Clinic, Rochester, Minn, found that CT screening of high-risk patients detects lung cancer at a smaller size and earlier stage compared with chest radiography and other clinical practice diagnostics. However, CT screening also identifies many benign, uncalcified lung nodules as false positives.
The Mayo research team used low-dose, spiral chest CT to screen 1,520 people age 50 and older who were at high risk for lung cancer. They analyzed lung characteristics, nodules, and additional findings and compared the results with previous chest radiograph-based studies and current clinical practice diagnosis.
The study reported that 1,049 of the 1,520 people screened (69%) had uncalcified lung nodules. Using CT screening, the researchers detected 38 cases of lung cancer, including 35 cases of non-small cell lung cancer (NSCLC); 60% of these cancers detected were at the most curable stage.
The study also reported that, over a 3-year period, 98% of uncalcified lung nodules detected by CT represented false- positive findings. In these cases, further testing was required to determine if the imaging findings were lung cancer or benign nodules.
The American Cancer Society reports that the 5-year survival rate for all stages of NSCLC combined is 15%. For small cell lung cancer, the 5-year survival rate is 6%. However, if NSCLC is found and surgically treated before it has spread beyond the lung, the 5-year survival rate increases to 50%. On the whole, only 15% of lung cancer patients are diagnosed before their cancer has spread.
Diagnostic Imaging Leads US Health Care Equipment Leasing Business
According to a newly released study, diagnostic imaging leasing is the most active health care equipment leasing category, accounting for more than 65% of all health care lease financing.
The study, Healthcare Equipment Leasing 2003: US Market Dynamics and Outlook, was conducted by the Equipment Leasing Association, Arlington, Va, and R.S. Carmichael & Co, White Plains, NY. The study focused on the leasing practices of hospitals, outpatient centers, and other providers, with respect to revenue-producing and cost-saving equipment.
Among the report’s findings:
“The estimated size of the 2002 US health care equipment leasing market was $5.8 billion.
“The average annual growth rate of the market is forecast to be 8.5% through 2005. The health care equipment leasing market is projected to reach $7.4 billion in volume by 2005.
“The continuing shift of health care away from hospitals to outpatient facilities is leading to the acquisition of new equipment and expanded use of lease financing.
“Future health care equipment leasing increases will be stimulated by technology enhancements, especially those related to digital systems integration.
Room at the Top
Providing the keynote speech at the recent meeting of the Healthcare Information Management Systems Society (HIMSS) in San Diego, General Electric CEO Jeffrey R. Immelt revealed to attendees just how much the sixth largest company in the world spends on health care for its employees, foreshadowing an impending health care crisis. “I have a natural hedge on my best days,” Immelt explained. “I make as much on health care as I spend on it for my employees. For companies like Ford and GM, there are more dollars of health care in a car than there is steel.” GE Medical Systems profits were about $1.5 billion in 2002, and the company spent more than $1.4 billion on health care benefits in 2002. With health care costs rising at five times the rate of the GDP, Immelt urged hospitals to become more productive, but cautioned against investing in information technology (IT) without first examining processes. “We have to together invest to make providers more productive….My concern is that together we have underperformed the promise of IT in this room.”
Atul Minocha has been appointed chief marketing officer and divisional vice president of Eastman Kodak Company’s Health Imaging Group, Rochester, NY. Minocha also continues in his role as director of marketing for health imaging’s Americas organization.
Andrew Maidment, PhD, DABR, formerly director of radiological imaging physics and assistant professor of radiology at Thomas Jefferson University in Philadelphia, is now the chief of the physics section at the Hospital of the University of Pennsylvania Department of Radiology, also in Philadelphia.
Agfa HealthCare, Greenville, SC, has purchased a minority stake in Med2Rad Srl, an Italian medical software company. Med2Rad developed the “Elefante” RIS that is currently installed in more than 75 Italian hospitals. The move is part of Agfa’s plan to expand its RIS portfolio…GE Medical Systems, Waukesha, Wis, was presented with the 2002 Best Capital Equipment Supplier Award at the 12th Annual HealthCare Executive Forum. The award was determined as part of a survey administered by Networking Consulting Information (NCI). In addition, the Association of University Radiologists (AUR) and GE Medical have jointly announced the selection of four junior academic radiology investigators to receive 2-year GE-AUR Radiology Research Academic Fellowship (GERRAF) awards for 2003: Elizabeth S. Burnside, MD, MPH, MS, assistant professor of radiology and chief, Breast Imaging, University of Wisconsin; John A. Carrino, MD, MPH, assistant professor of radiology, Harvard Medical School, and staff radiologist, Brigham and Women’s Hospital; Mukesh G. Harisinghani, MD, instructor in radiology, Harvard Medical School, and assistant radiologist, Massachusetts General Hospital; and Martina M. Morrin, MD, assistant professor of radiology, Harvard Medical School, and staff radiologist, Beth Israel Deaconess Medical Center. The fellowships are presented annually to support advanced research projects in the areas of patient outcomes research, technology assessment, and informatics. GE Medical has also announced that its Senographe 2000D is the first full field digital mammography system eligible to receive Mammography Quality Standards Act (MQSA) accreditation from the American College of Radiology…Mirada Solutions Ltd, Oxford, United Kingdom, and Amersham Health, UK, a provider of radiotherapy products, have agreed to jointly develop image analysis software to support Amersham’s molecular diagnostic products…IMCO Technologies, Pewaukee, Wis, and Swearingen Software, Houston, have announced an agreement in which both companies will have contact with each other’s customers and prospects for PACS and RIS systems…Agfa HealthCare, Ridgefield, NJ, has been named the Number One Voice Recognition Solution by KLAS Enterprises, a consulting company that monitors the performance of health care information technology software vendors. Agfa received the award for its Talk Technology TalkStation solution.