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Statement of ownershipEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Tags: Letters to the Editor Source Type: journals

Forthcoming ArticlesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Tags: Letters to the Editor Source Type: journals

Re: “Do You Purge Your PACS Archive? Should You?”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Dr Ramin Khorasani [] raised important questions regarding the purging of digital images. I offer a few comments from the perspective of the law of evidence. The law of evidence regarding radiologic images evolved during the film-only era, many years before the advent of digital technology [], as did the image retention regulations of the individual states. I agree with Dr Khorasani [] that “it is unclear…when regulatory requirements for image storage will be modified to reflect the transition from analog to digital.” The history of the law of evidence for film-based images suggests the requirements will be changed ...
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Anthony R. Benedetto Tags: Letters to the Editor Source Type: journals

Author's ResponseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I would like to thank Schmitz et al for their comments on my article on MR-guided focused ultrasound (MRgFUS) as a disruptive technology []. Although it is hard to argue against having surgical margins for the resection of a malignant tumor, in fact, most lumpectomies for breast cancer today are followed by radiation therapy, reducing the recurrence at 4 years from 24% to 6% []. This would imply that 25% of the time surgeons think that they have margins, they don't. Lumpectomy, even with apparent margins, is really a debulking procedure and is not curative in its own without follow-up radiation therapy. (Source: Journal of...
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: William G. Bradley Tags: Letters to the Editor Source Type: journals

Re: “MR-Guided Focused Ultrasound for Malignant Tumors: The Importance of Margins”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We read with interest the recent article by William G. Bradley [] on MR-guided focused ultrasound (MRgFUS) as a potentially disruptive technology. Dr Bradley described MRgFUS as a technical innovation that can overturn the existing dominant technology (ie, surgery) in the market. We believe, however, that to compete with surgery for the treatment of malignant tumors in clinical practice, one important issue has been overlooked in the current literature: the ability to perform accurate, noninvasive margin assessment before and after MRgFUS. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Annemarie C. Schmitz, Maurice A.A.J. van den Bosch, Kenneth G. Gilhuijs Tags: Letters to the Editor Source Type: journals

Lee TherosEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As the sound of taps faded in Arlington National Cemetery in Arlington, VA., at the funeral of Lee Theros, someone said, “He was a teacher.” Of all of the elements in Lee Theros's career, teaching was his primary focus and talent. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Otha Linton Tags: They Were Giants Source Type: journals

From the ACR Grassroots: Why Residents Should Fight for Medicare Coverage of CT ColonographyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Behind us the Capitol shimmered like a mirage in the midday heat. A blast of air conditioning refreshed me as we entered the House of Representatives office building to meet with the staff of our next congresswoman. Washington, DC, was buzzing with talk of health care reform, and my head was filled with terms like utilization rates, clinical appropriateness, and more acronyms than I had learned so far in my radiology studies. I wondered, in exciting and uncertain times such as these, what impact the decisions made within these walls will have on us as residents, and the future of the career we have chosen? (Source: Journal...
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Ainsley V. MacLean Tags: The Residents' and Fellows' Column Source Type: journals

Anesthetic and Steroid Injections for Musculoskeletal PainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Inflammation in the musculoskeletal system is a common source of pain []. When symptoms do not respond to conservative treatment, the image-guided injection of a combination of short-acting anesthetic and anti-inflammatory steroid can often offer relief, especially in patients with acute exacerbations of symptoms []. In joints and the spine, the anesthetic can provide immediate pain relief that lasts 4 to 5 hours and confirms the source of pain []. The steroid begins to work after 1 to 2 days and reaches maximum effectiveness in 5 to 7 days []. The duration of pain relief varies depending on many factors, including the sev...
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Janet C. Miller, William E. Palmer, Allan H. Goroll, James H. Thrall, Raul N. Uppot Tags: Utilization Rounds of the MGH Source Type: journals

Diagnostic Medical Physics Procedures Carrying ReimbursementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a previous article in this journal, Nick Detorie [] outlined the procedures performed by medical physicists in radiation oncology that are covered under Current Procedural Terminology® (CPT®) code 77370, special physics consult. Additionally, one of the present authors (J.M.H.) described the fusion of images, such as MR and PET/CT to CT planning images in radiation oncologic procedures, work by medical physicists that may be reimbursed through the special physics consult code []. As described in both of these articles, the requirements for reimbursement under CPT 77370 are as follows. (Source: Journal of the American ...
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: James M. Hevezi, J. Anthony Seibert, Libby Brateman Tags: The Medical Physics Consult Source Type: journals

Treatment Delays Using an Automated Afterloading Low-Dose-Rate Brachytherapy SystemEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Significant interruptions are frequent using remote afterloading LDR techniques, reducing the effective dose rate. Careful monitoring of such interruptions is warranted. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Colleen M. DesRosiers, Eric Slessinger, Jeanne Schilder, Frederick Stehman, Indra J. Das, Paul DesRosiers, Higinia Cardenes, Peter A.S. Johnstone Tags: Original Articles Source Type: journals

Comparison of Two Methods to Transmit Clinical History Information From Referring Providers to RadiologistsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The manual entry of clinical information introduces a high rate of discrepancies, most of which are clinically significant. These discrepancies highlight the need for better communication between referring providers and radiologists. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Rajan Agarwal, Michael H. Bleshman, Curtis P. Langlotz Tags: Original Articles Source Type: journals

Insight From Patients for Radiologists: Improving Our Reporting SystemsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Whatever system revisions are attempted to increase the patient-centeredness of care as regards to radiology reporting, patients will need to be able to choose their preferred levels of access and will need to have the option of accessing full details. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Annette J. Johnson, Doug Easterling, Linda S. Williams, Sharon Glover, Richard M. Frankel Tags: Original Articles Source Type: journals

The Association Between Hospital Outcomes and Diagnostic Imaging: Early FindingsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: This study lays the foundation for further exploration of the relationship between resource use and the clinical and economic outcomes associated with imaging utilization. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: David W. Lee, David A. Foster Tags: Original Articles Source Type: journals

Self-Referral of Imaging and Increased Utilization: Some Practical Perspectives on Tackling the DilemmaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Health care costs are higher in the United States than in any other country in the world, and imaging services have been growing much more rapidly than other services. Studies have shown a tendency for increased utilization of services, including imaging services, when referring physicians have ownership interest in the services. In recent years, the CMS has taken some action with respect to how it pays for imaging, including reducing physician payments when multiple images are taken on contiguous body parts during the same visit, establishing a cap on payments for certain imaging services, and imposing an antimarkup rule ...
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Donald H. Romano Tags: Original Articles Source Type: journals

ACR Colon Cancer Committee White Paper: Status of CT Colonography 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Supported by third-party payer reimbursement for screening, CTC will continue to further transition into community practice and can provide an important adjunctive examination for colorectal screening. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Elizabeth G. McFarland, Joel G. Fletcher, Perry Pickhardt, Abraham Dachman, Judy Yee, Cynthia H. McCollough, Michael Macari, Paul Knechtges, Michael Zalis, Matthew Barish, David H. Kim, Kathryn J. Keysor, C. Daniel Johnson Tags: Original Articles Source Type: journals

ACR Presidential Address: With Change Inevitable, Can We Survive?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The universe of medical practice is changing at an ever increasing rate, an exponentially increasing rate. In examining Earth's history from the beginning of time, it is not necessarily change per se that has threatened countless species but the rate of change that has challenged species survival. Darwin's thesis indicates that those who are most able to adapt to change will be more likely to survive. Medical technology, especially imaging technology, has been on a exponential growth curve for the past 2 decades, dramatically changing not only the field of medical imaging but the environment of all of medicine. Change in o...
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Arl Van Moore Tags: Original Articles Source Type: journals

HospitalityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
How hospitable are our hospitals, particularly our radiology departments? When patients and health professionals visit our workplaces, how welcoming do they find the environment and the people who work in it? Do our radiology departments strike them as fortresses, evidently designed to discourage visitors and defend turf? Or do we present an accommodating, pleasant, and even warm atmosphere? Much hangs in the balance. The radiologists working in a department may be the best lesion detectors and differential diagnosticians in the world, but if the reception staff or technologists are cold and surly, patients will leave with...
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Richard B. Gunderman Tags: Invisible to the Eye Source Type: journals

Colonic and Cardiac Imaging: Two Steps Forward…Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
With few exceptions, the traditional coding and payment paradigm for cross-sectional imaging has been based on body regions, not individual organs. For example, there are no Current Procedural Terminology (CPT) codes that explicitly describe CT of the kidneys, ultrasound of the pancreas, or MRI of the liver. For coding purposes, these are each considered abdominal studies. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Richard Duszak Tags: The Bottom Line Source Type: journals

State Advocacy: Establish Relationships, Find LobbyistsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A new feature of the AMCLC is an “open mic” session in which those attending the meeting have an opportunity to bring up issues to the ACR Council leadership. This year, a short program of invited speakers made presentations, after which the audience reacted to the presentations and also brought up related issues. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Kenneth W. Chin, Edward I. Bluth, Beverly Coleman, Alan D. Kaye, Members of the ACR Council Steering Committee Tags: 86th Annual Meeting and Chapter Leadersip Conference Source Type: journals

Medicine's Geek SquadEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The new administration is using its considerable influence to motivate all of medicine to move to electronic medical records (EMRs), the cornerstone of its health care reform effort. This pivotal change presents some significant challenges for medicine. On the other hand, there are some real opportunities for radiology. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Howard B. Fleishon Tags: Opinion Source Type: journals

What Happened to Payment Reform?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Giving money and power to government is like giving whiskey and car keys to teenage boys.—P. J. O'Rourke I watched President Obama's July 22 press conference, the one in which all but two questions focused on health care reform. Maybe some of you listened to the president as I did: all tensed up, waiting on edge as each question was asked…in suspense over how he would answer…waiting to hear him utter the dreaded two words—“payment reform.” (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: Bruce J. Hillman Tags: Editorial Source Type: journals

One Patient at a TimeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Wisdom is characterized by the ability to draw inference from assimilated knowledge and experience. The process of becoming wise cannot be taught, quantified, or easily explained, which is why we value wisdom so highly. Physicians who are diligent and open minded become wise over time, blending new medical knowledge with experience. The wisest physicians have insights into their patients that defy easy description or explanation—a kind of sixth sense about what is happening with their patients that can be extraordinarily important in good patient outcomes. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - October 28, 2009 Category: Radiology Authors: James H. Thrall Tags: ACR Chair's Memo Source Type: journals

Forthcoming ArticlesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Tags: Other Content Source Type: journals

Author's ReplyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Paul A. Larson, MD, and Judy Burleson have identified a colossal loophole overlooked in my recent analysis of Medicare's Physician Quality Reporting Initiative (PQRI) program []. They are correct, and I thank them for their interest and their attention to detail. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Richard Duszak Tags: Letters to the Editor Source Type: journals

Re: “P4P: Pragmatic for Practice”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We appreciate the attention that Richard Duszak Jr, MD, [] brought to the Physician Quality Reporting Initiative (PQRI) program in his column “P4P: Pragmatic for Practice” in the July 2009 issue of JACR. However, we must comment on an inaccuracy that perpetuates a common misconception about the program. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Paul A. Larson, Judy Burleson Tags: Letters to the Editor Source Type: journals

Author's ReplyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I thank Stephen Amis Jr, MD, for his letter to the editor concerning my opinion article “Over-Regulating Radiology Residencies: The Unforeseen Costs” []. Respectfully, I stand behind my opinion, and I would like to respond to several of Dr Amis's points directly. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Levon N. Nazarian Tags: Letters to the Editor Source Type: journals

Re: “Over-Regulating Radiology Residencies: The Unforeseen Costs”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Levon N. Nazarian, MD, [] raised several issues in his opinion article “Over-Regulation of Radiology Residencies: The Unforeseen Costs,” which appeared in the June issue of JACR. He cites implementation of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project in 2001, the advent of the ACGME duty-hours standards in 2003, and the more recent requirement for developing and maintaining resident learning portfolios as all having unforeseen consequences, or “costs,” that detract from the education of residents and the efficient functioning of academic radiology departments. Although some of th...
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: E. Stephen Amis Tags: Letters to the Editor Source Type: journals

Franklyn AngellEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
He often introduced himself as the “Angell of Mercy,” which was true in the last 18 years of his life. During those years, Frank Angell was the chief of radiology at Mercy Hospital in Baltimore and a clinical professor at the University of Maryland School of Medicine. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Otha Linton Tags: They Were Giants Source Type: journals

On the Importance of Organized MedicineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The rigors of residency are obvious to those who read this column. However, solely showing up to work, interpreting studies, going home, and studying is insufficient to mature into a high-quality radiologist. A profession is defined by its ability to educate and qualify its own members and to regulate itself. As such, we as physicians have a collective responsibility to our professional membership, and as the next generation of radiologists who will inherit the health care system, we should have an exceptional interest in its structure. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Alexander Ding, Jason W. Sharp Tags: The Residents' and Fellows' Column Source Type: journals

New 2009 Payment Levels for Placement of Interstitial DevicesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the past, interstitial devices implanted in solid tumors for image-guided radiation therapy were reimbursed in the hospital outpatient setting at a low level, such that interventional radiologists and surgeons performing these procedures were reluctant to provide the service at a loss to the hospital. In 2009, the Centers for Medicare & Medicaid Services (CMS) reviewed the 2007 hospital outpatient claims data for these services and, in consideration of the services clinical characteristics, decided to modify the reimbursement rates of these services. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: James M. Hevezi, Wendy Smith-Fuss Tags: The Medical Physics Consult Source Type: journals

Optimizing Communication of Critical Test ResultsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The effective communication of test results is an important element of quality in radiology []. More recently, the optimal communication of critical test results (CTR) has been defined as an important national patient safety goal []. In a previous column 2 years ago, I briefly described some of the broad challenges and technical requirements for addressing this important quality-of-care imperative []. I continue to receive numerous questions and requests for information on this topic, most recently after presenting CTR communication challenges at the opening session of the national meeting of the Society for Imaging Inform...
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Ramin Khorasani Tags: Bits and Bytes Source Type: journals

Discrepancies in Reporting the Vertebral Level of Abnormality in MR of the SpineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Errors in lesion level on spinal MR do occur in radiology reports. The number of unidentified errors is substantially higher than that of identified errors. Care should be taken before signing off on radiology reports to identify erroneous mentions of the vertebral levels of abnormalities. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Minal Jagtiani Sangwaiya, Shyla Saini, Rajiv Gupta, Albert J. Yoo, Markus Stout, Keith Dreyer, Mannudeep Kalra Tags: Original Articles Source Type: journals

Analyzing the Differential Impact of Radiology Information Systems Across Radiology ModalitiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Although the additional time needed to navigate through the RIS screens might have (unexpectedly) increased the radiologists' interpretation cycle times, the overall benefits of the RIS outweighed this negative effect in this study. Before the RIS installation some clinical background information was not available to the radiologists at the time of interpretation. As a part of the RIS implementation the radiology practice introduced several disciplined data collection procedures to make such information readily available downstream. These procedures significantly reduced the percentage of mammographic studies t...
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Atanu Lahiri, Abraham Seidmann Tags: Original Articles Source Type: journals

Enhancing Mutual Understanding Between Radiology Chairs and Hospital CEOsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Many radiologists work in hospital-based practices, and many hospitals rely on radiology for revenue to sustain their other health care programs and keep patients' and referring physicians' satisfaction high. It is vital that radiology department chairs and hospital CEOs work well together. Yet they often come from very different backgrounds and operate with very different sets of assumptions and objectives. The authors review these differences and suggest strategies radiologists and radiology leaders can adopt to improve their relationships with hospital administrators. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Richard B. Gunderman, Giles W.L. Boland Tags: Original Articles Source Type: journals

Quantifying Radiation Safety and Quality in Medical Imaging, Part 3: The Quality Assurance ScorecardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The practice of medical imaging is fraught with inconsistency as it relates to quality assurance, which is due in part to the lack of standardization and objective quality-centric data. By applying the scientific methods of Shewhart and Deming to medical imaging quality assessment, one can devise an objective, data-driven quality model, encompassing the various steps and processes that take place within the medical imaging chain. Through automated recording, tracking, and analysis of these quality data elements, a quantitative scorecard can be derived that provides an objective measure of quality performance, relating to e...
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Bruce I. Reiner Tags: Original Articles Source Type: journals

ACR White Paper: Task Force to Evaluate the Value Add Impact on Business ModelsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Radiology practices are seeing both evolutionary and revolutionary changes in their business models. The Task Force to Evaluate the Value Add Impact on Business Models was charged with considering how radiologists and their practices add value in these novel settings. Both traditional and novel forms of added value were considered. Types of new business models that were evaluated included hybrid groups of radiologists and other practitioners, regional or national megagroups, and novel services both within and beyond the traditional purview of radiology practice. Recommendations for both how to measure and how to capture th...
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Frank Lexa, Jonathan William Berlin, Giles W.L. Boland, Geoffrey Giles Smith, Mark D. Jensen, David J. Seidenwurm, Richard Hoppe, Robert Stroud Tags: Original Articles Source Type: journals

ACR Appropriateness Criteria® on Acute Respiratory IllnessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a patient with acute respiratory illness (cough, sputum production, chest pain, and/or dyspnea), the need for chest imaging depends on the severity of illness, age of the patient, clinical history, physical and laboratory findings, and other risk factors. Chest radiographs seem warranted when one or more of the following are present: age ≥ 40; dementia; a positive physical examination; hemoptysis; associated abnormalities (leukocytosis, hypoxemia); or other risk factors, including coronary artery disease, congestive heart failure, or drug-induced acute respiratory failure. Chest CT may be warranted in complicated case...
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Lacey Washington, Arfa Khan, Tan-Lucien Mohammed, Poonam V. Batra, Jud W. Gurney, Linda B. Haramati, Jean Jeudy, Heber MacMahon, Anna Rozenshtein, Kay H. Vydareny, Larry Kaiser, Suhail Raoof Tags: Original Articles Source Type: journals

Significant New HIPAA Provisions in the Recent Economic Stimulus PackageEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Last February, Congress enacted the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the recent federal stimulus package. The HITECH Act provides more than $19 billion in funding to promote the adoption of electronic medical records in the health care industry. However, the prospect of making health information available electronically has raised privacy and security concerns. Accordingly, Congress also included in the HITECH Act substantial changes to the privacy and security requirements of the federal Health Insurance Portability and Accountability Act (HIPAA). These changes will re...
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Peter B. Mancino Tags: Legal Counsel Source Type: journals

Leading in a Crisis, Part 2: Succeeding in BattleEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Never waste a good crisis. In the most recent column in this series, I considered an overview of the issues at stake in crisis leadership and the predictable temporal phases of crisis leadership []. I return to the topic to focus on those factors that can help leaders perform well in the pressure and confusion of a crisis and succeed in difficult times. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Frank James Lexa Tags: Profiles in Leadership Source Type: journals

Errors, Chasms, and RoadmapsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Timely health policy decisions may seem like a self-contradictory phrase in Washington. After all, 32 years passed after its founding in 1906 before the US Food and Drug Administration was even granted authority to test drugs. It was 3 decades from the time Franklin Roosevelt proposed Medicare until it was enacted in 1965. And the current spate of political activity has its origins in 1993, during the Clinton administration. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Michael J. Pentecost Tags: Washington Watch Source Type: journals

Data Presentation Bias: A Source of Potential Error in Radiology Scientific PublicationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I wish to draw attention to a new source of potential reader error that may occur as a result of the manner in which the results of a research study are presented in an article. I have termed this “data presentation bias.” (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Mervyn D. Cohen Tags: Opinion Source Type: journals

Coke vs PepsiEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
That is the essence of science: ask an impertinent question and you are on the way to the pertinent answer.—Jacob Bronowski Over the years, I frequently have carped verbally and in print at the difficulty of providing optimal radiologic care with a less than scientifically stellar clinical knowledge base. For the most part, people have considered me a crank and pointed to the rise in imaging utilization as evidence that we're doing something right. It's hard to dispute an argument like that without getting too pointy headed and unpopular. Nonetheless, the thoughts linger: How much of all that utilization is truly positi...
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: Bruce J. Hillman Tags: Editorial Source Type: journals

ACR Registries Serve Multiple PurposesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
One of the singular advantages of working in the digital age is the ability to collect data that can be aggregated and shared for multiple purposes, including improvement of the quality of care offered to our patients and improvement of our management abilities. To help accomplish these goals, the ACR has taken a leadership role in the development of data registries that support the practice of radiology. These registries touch on diverse aspects of radiology and will become increasingly important in the future to document and improve the quality of care, to meet a variety of compliance requirements, and to meet ever more ...
Source: Journal of the American College of Radiology : JACR - September 30, 2009 Category: Radiology Authors: James H. Thrall Tags: ACR Chair's Memo Source Type: journals

Forthcoming ArticlesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - August 31, 2009 Category: Radiology Tags: Other Content Source Type: journals

Robert N. CooleyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
“Bob Cooley claimed that a large part of his success was due to the fact that the right people came along at the right time to help him, but it was he who produced the environment and who exercised the magnetism that attracted them,” wrote his protégé and successor, Melvyn Schreiber. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - August 31, 2009 Category: Radiology Authors: Otha Linton Tags: They Were Giants Source Type: journals

Dual-Source Computed Tomography for the Evaluation of NephrolithiasisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Unenhanced low-dose multidetector computed tomography (CT) is recognized as the most accurate examination technique for the evaluation of patients with renal or ureteral calculi []. It shows the precise locations and sizes of renal stones within the kidneys, the ureters, and the bladder. If multidetector CT shows a ureteral stone (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - August 31, 2009 Category: Radiology Authors: Janet C. Miller, Dushyant V. Sahani, Brian H. Eisner, James H. Thrall, Raul N. Uppot Tags: Utilization Rounds of the MGH Source Type: journals

ROC, LROC, FROC, AFROC: An Alphabet SoupEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Receiver operating characteristic (ROC) analysis is a well-established method for assessing binary classification task performance. It was first used by the US Army to increase the correct detection of aircraft from radar signals during World War II. Later, ROC was applied to medicine for evaluating diagnostic testing performance and has since been extensively applied in various areas of medical research. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - August 31, 2009 Category: Radiology Authors: Xin He, Eric Frey Tags: Technology Talk Source Type: journals

The New and the OldEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Old and new make the warp and woof of every moment. There is no thread that is not a twist of these two strands.—Ralph Waldo Emerson One of the most amusing facets of 2002's unlikely cinema hit My Big Fat Greek Wedding is a character instantly recognizable to any liberally educated person. Played by Michael Constantine, he is Kostas “Gus” Portokalos. He is the father of the story's protagonist, Toula, a 30-something woman living at home but striving to break free from a family and culture that want nothing more than for her “to make Greek babies and feed everyone.” Gus, the arch conservative, is convinced that a...
Source: Journal of the American College of Radiology : JACR - August 31, 2009 Category: Radiology Authors: Richard B. Gunderman Tags: Invisible to the Eye Source Type: journals

Radiology Coding, Reimbursement, and Economics: A Practical Playbook for HousestaffEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As radiologists-in-training, residents and fellows have little time to devote to understanding the complex and often confusing world of reimbursement and radiology economics. At best, housestaff are afforded only a modicum of exposure to the economics of medicine. Although most training programs try to provide some information on the subject, between learning radiology, taking call, and juggling life outside the hospital, the majority of residents and fellows have little time or energy to learn about the economics of radiology. Furthermore, information on medical economics and radiology has only occasionally been directed ...
Source: Journal of the American College of Radiology : JACR - August 31, 2009 Category: Radiology Authors: W. Banks Petrey, Bibb Allen, William T. Thorwarth Tags: Original Articles Source Type: journals

Factors Influencing Subspecialty Choice Among Radiology Residents: A Case Study of Pediatric RadiologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Multiple factors account for subspecialty selection among residents, and it is useful to understand these factors when attempting to recruit residents to specific subspecialties. To ease the workforce shortage in pediatric radiology, advanced and varied imaging modalities, numerous job opportunities, and well-paid private practice positions should be emphasized to residents. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - August 31, 2009 Category: Radiology Authors: Ryan W. Arnold, Marilyn J. Goske, Dorothy I. Bulas, Ellen C. Benya, Jun Ying, Jonathan H. Sunshine Tags: Original Articles Source Type: journals