Picture Your Future

March 2008 Blog Archive

Monday, March 31, 2008
PET Beats Other Scans for in Detecting Coronary Artery Disease
If you are concerned about your risk for coronary artery disease then you've probably looked into getting preventive health screening. This type of screening is important to catching the disease in the early stages so that you can correct the problem and save your heart. However, if you're going with the standard screening recommendation from your doctor, you might not be getting all of the care that you need in these important early stages.

That's because there are many different ways to screen for coronary artery disease but it's only recently been discovered that the most effective of these ways is through the PET scan. Research found that although the MRA, CTA and perfusion imaging are all good methods of screening for this disease, none of them is nearly as good as using a PET scan.

"What we found after looking at 19 studies and more than 1,400 patients is that PET's high specificity and sensitivity are better than almost all forms of functional imaging and likely all anatomical imaging," said study co-author Dr. Kiran Nandalur, a staff radiologist at William Beaumont Hospital in Royal Oak, MI.

This isn't information that's coming from brand new patients either. This study reviewed scans that took place over the last thirty years! That presents some solid evidence that the PET scan is the one that you want to ask your doctor about if you're concerned about this aspect of your health.

Question of the Day: Which scan have you heard most often as recommended for coronary artery disease?

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Friday, March 28, 2008
Men Must Be Pushed to Get Health Screening
Both men and women need to get preventive health screening. The types of screening that are necessary vary by gender but both sexes need to make regular appointments to get annual screening if they want to prevent disease through early detection and treatment. Unfortunately, it's a lot more common for women to go ahead and get this type of medical care than for their male counterparts to do so.

There are several reasons that women may be more open to getting annual health screening than men are. For one thing, women are just used to getting this type of medical care since they tend to see their gynecologists on a regular basis for annual health screening. To add in other kinds of preventive imaging throughout their lives doesn't seem like a big leap. Men, who are less likely to see doctors in general, may find it difficult to start incorporating preventive health care into their lives.

Additionally, men may take a macho approach to the whole process. They don't want to go to a doctor unless they're practically on the verge of death because they don't want to be seen as weak and in need of care. This causes them to put off those appointments until a time when it may be too late. When not nipped in the bud, diseases spread and may become untreatable. As a result, it is important for the medical community to educate men as to the importance of preventive health care.

Learn more about the preventive imaging gender differences between men and women here.

Question of the Day: Would you be more or less likely to get annual screening if you were the gender opposite of what you really are?

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Thursday, March 27, 2008
Improved Alternative to Mammogram Won't Launch in US Yet
Most women know that they should get a mammogram each year after a certain age in order to screen for breast cancer. However, many women really dislike the mammogram process because it is uncomfortable at best and may be considered painful by some. A new imaging system has been designed which provides a much mroe comfortable alternative to the mammogram. However, this new system won't be available in the United States for some time to come.

The alternative to the mammogram is called Digital Breast Tomosynthesis (DBT). You can learn more about it here but basically it's a method of creating a 3D mammogram without the compression and invasiveness that are experienced with the traditional mammogram. Although the product was developed here in the United States, it is going to first be launched in Europe.

The main reason for this is because different countries each have different standards for regulating this type of equipment. The company which deigned the product doesn't have the ability to market to all of the different regulatory boards at once. It is beginning with Europe and will move forward to seek FDA approval in the United States at some point in the future. There is hope that may happen before the end of the year.

Question of the Day: Would you be interested in a mammogram alternative?

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Wednesday, March 26, 2008
Primary Care Doctors Should Be Responsible for Post-Cancer Screening
People who have survived cancer know about the importance of preventive health screening. They know that the ancer could come back at any time. They also know that other medical problems might crop up and that it's easiest to treat disease when it can be idenitifed early and nipped in the bud.

However, the process of getting preventive screening after treatment for cancer is not as streamlined as you might think. The cancer patient relies on the doctor's recommendations for getting future screening done. As time passes and the cancer patient is doing well, the need to see the oncologist is drastically reduced. The patient is much more likely to see a primary care doctor who may not be so quick to recommend screening.

There is an identified need among cancer survivors to learn about when and how to get proper screening for return of the cancer as well as the development of new disease. This need can be met through a commitment by primary care physicians to educate their patients about the timing and need for proper screening.

Learn more about this issue here.

Question of the Day: Whose responsibility is it to make sure that cancer survivors are getting proper screening after the disease has been treated?

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Tuesday, March 25, 2008
Prostate Cancer Treated Better with Use of MRI
A new study has revealed that it is important for patients with prostate cancer to get an MRI scan prior to treatment for the cancer. That's because the MRI has the ability to detect the depth and spread of the disease. This means that doctors can more properly evaluate the correct treatment and can be more aggressive in their treatment approach as necessary.

Basically, it is assumed that prostate cancer is going to be concentrated in the prostate capsule. However, there are many instances in which the cancer has already spread to surrounding areas (in which case it is called extracapsular extension). An MRI can see those areas and allow doctors to determine that it is necessary to not only treat the prostate cancer but also to treat the extracapsular extension.

The MRI is a powerful tool for screening and can allow for detection of the disease in the very early stages. Catching it in time to direct treatment allows the patient the optimum health experience.

Question of the Day: If your doctor didn't recommend an MRI before starting prostate cancer treatment, would you ask about getting one done?

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Monday, March 24, 2008
Imaging Doctors Must Communicate to Be Effective
The primary trait that you probably want your preventive imaging doctor to have is skill. You need a doctor who is familiar with the kind of work that you are seeking to have done in order to identify, prevent and treat disease in your body. Beyond that, your next favorite trait might be something along the line of patience, kindness or being easy to talk to. After all, you want a doctor who is going to be able to make you feel safe and comfortable as you get your screening taken care of each year.

However, a new study indicates that the most important trait for imaging and preventive health doctors to have might be communication. And that's not just communication with you as a patient. It's communication with the other doctors and staff in the radiology departments where they work.

Essentially, it boils down to the importance of everybody in the process of treatment doing their jobs well and conveying that information to the others throughout the process. For example, the doctor who first orders the screening needs to know what type of procedure should be done and what to look for. That information must be passed along to the technicians who are going to be doing the actual screening process. Likewise, the information gleaned there must be effectively communicated back to the imaging doctor in order to make sure that the most beneficial treatments are performed.

Preventive health care is all about nipping problems in the bud. We all know that problems are resolved more quickly when communication is open and complete. It makes sense then that this type of communication is of utmost important in the imaging field.

Question of the Day: Why do you feel that communication is key to an imaging department's success?

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Friday, March 21, 2008
Strongest Modern MRI Deemed Safe
It's been mentioned here in the past that there's a competition in the world of MRI manufacturing to create the biggest and best MRI imaging machine. Because the magnets of MRIs are measured in Teslas, this competition is often called "the Tesla wars". And it appears that the 9.4 Tesla MRI has won its latest battle. The machine has been deemed safe after three years of trials to make sure that it could proceed to be used.

"The powerful MRI will soon provide physicians with a real-time view of biological processes in the human brain at an unprecedented level of detail."

It is believed that this increased detail will make it possible for doctors to offer better treatment to their patients. They may be able to diagnose diseases in earlier stages in order to make prevention and treatment more successful. They may also be able to use the new MRI to learn more about the human brain in order to develop additional methods of treatment for many types of disease.

It was necessary to conduct safety trials because the strength of the machine can cause side effects for patients. There is always concern about safety when increasing this strength. Extensive studies revealed that the difference in side effects between this machine and MRIs currently in use was minimal and the machine was determined to be safe.

Question of the Day: Would you have any hesitations about using the new MRI because of its enhanced strength?

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Thursday, March 20, 2008
Diagnostic Imaging Implemented Due To Medical Error
It is tragic when doctors make a big mistake when taking care of a patient during any procedure. That was just such the case recently in Minnesota when a patient when into the hospital to have a tumorous kidney removed and her healthy kidney was removed by error. There is just no excuse at all for that kind of error and the hospital has been apologizing profusely for the problem.

In response to the problem, the hospital has implemented a new procedure which calls for diagnostic imaging. The error was made because the surgical team was following information on a medical chart that had been documented prior to surgery. The new protocols will rewuire the "surgical care team to verify laterality using the diagnostic imaging study before the surgery begins". This should protect future patients from this type of problem.

We typically think of preventive imaging tools being used to detect problems like cancer. However it is possible for them to be used in order to act in a sort of checks-and-balances system for cases such as these. Because we have so many medical tools at our disposal, it makes sense to make use of them in any way we can to assist patients in receiving better care.

Question of the Day: What is the worst medical horror story that you have ever heard?

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Wednesday, March 19, 2008
Optical Light May Supplement MRI for Alzheimers
Many advances have been made in recent years in terms of imaging medicine for detecting Alzheimers. For example, it was found not that long ago that PET scans could be used to better distinguish whether a person really had Alzheimers or whether they instead had the similar condition of dementia.

In spite of the advances, it is still most common to use the MRI to scan for signs that someone is suffering from Alzheimers. However, the MRI may soon begin to be supplemented with the use of optical light imaging.

A recent study revealed that "near-infrared light may help detect microscopic signs of Alzheimer's disease in brain tissue". The belief by researchers is that this may be used as a way to improve early detection of the disease.

Question of the Day: Which method of Alzheimers imaging do you ultimately think will prove most successful?

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Tuesday, March 18, 2008
Resource to Remember
Have you ever wondered which preventive imaging tests you should be getting? There is a lot of conflicting information in the media about who should be getting screened for what. This is confused by the fact that newly released studies can alter the recommendations for testing.

However, there are some basic tests that are generally agreed upon by professionals which should be included in your regular exams. To get a better understanding of what these imaging tests are and when you should get them, you might want to bookmark The U.S. Preventive Services Task Force (USPSTF).

This resource provides detailed information as to which screening tests they recommend and which ones they don't. You should be aware of this information even if you opt to get a test that isn't on their recommendation list because this list is frequently used by insurance companies to determine whether or not they will help pay for your screening. (You can read a case here of someone who got four screening tests and was only reimbursed for one for this reason.)

In addition to relying on this resource, you should work in conjunction with your family doctor to determine which imaging tests are needed based on your medical condition and medical history.

Question of the Day: Which tests do you believe are most important in preventive imaging?

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Monday, March 17, 2008
Breast MRI Recommended as Part of Annual Exam
We have mentioned in the past that the breast MRI is gaining attention as an important preventive imaging procedure for women who are at risk of breast cancer. A new study goes so far as to suggest that some women should consider getting the breast MRI as part of their annual breast exam.

The study is based on research which looked at the effectiveness of mammograms, ultrasounds and the breast MRI in locating breats cancer tumors. At the end of the study, it was found that there was only a minor difference between the mammogram and ultrasound. (The mammogram was slightly better at detecting malignancy.) However, there was a thirty percent difference in favor or the ability of the breast MRI to detect problems.

The breast MRI isn't recommended for everyone. However, women over the age of 35 that are considered high risk should think about asking their doctors whether the breast MRI is important.

Question of the Day: What would be your reason for or against adding the breast MRI to your annual exam?

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Friday, March 14, 2008
PET Scan Recommended For Lung Cancer Screening
Patients who are believed to have trouble with lung cancer are often recommended for a series of imaging tests to confirm the presence and spread of the problem. Traditionally, the PET scan has not been one of those types of imaging tests. However, new guidelines put out by the National Comprehensive Cancer Network now recommend the PET scan as an important diagnostic tool in this area of disease prevention.

MRI scans and CT scans have traditionally been used for this type of preventive imaging. However it has been shown that the PET scan may be both more sensitive and more specific in detecting lung cancer. The use of the PET scan may also be linked with better survival rates for patients dealing with this disease.

There are certainly drawbacks to using the PET scan in comparison with the other types of preventive imaging technology available. For example, it isn't particularly good in the area of histology or study of the tissues. In cases where staging is changed because of a PET scan, a closer look at the histology may be in order. As a result, doctors may consider using a combination of the PET scan and other scan technology to get a complete picture of the treatment that is necessary.

Question of the Day: What benefit do you see the PET scan having in this area of medical research and treatment?

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Thursday, March 13, 2008
Helping Hands: Kindness in Preventive Health
There was an inspiring article recently in The Coloradoan which spoke about a woman's first-person story related to battling cancer. She speaks about trying to maintain a "can-do", upbeat attitude even as she underwent PET scans, CT scans and a lumpectomy.

But what is most inspiring is the way that she talks about how you can "pay it forward" while someone else is going through this type of treatment. She discusses the fact that we really need to be there for each other during our times of need. And she points out that this doesn't just mean sending a get well card but that it really means getting proactive about driving friends to their appointments and taking care of the little things in life that need to be dealt with during these times.

It's also important to note that educating others about the importance of preventive health screening is another way to "pay it forward". By sharing stories such as these, we can spread the word that it's possible to catch these illnesses early on and prevent them from becoming devastating aspects of our lives. As a result, we serve the purpose of not only helping those close to us but also lending a helping hand to lives we may never even know we touched.

Question of the Day: What type of help would you desire most from a friend who just found out that your preventive health screening turned up something negative?

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Wednesday, March 12, 2008
CTA Impacted By Obesity
Earlier this week we took a look at the CT Angiography which can be used to screen for risk of stroke. (Read the whole article here.) The primary focus of that article was to point out that there are different types of scanning technology that can be used to do this procedure and that they emit different levels of radiation which patients may want to know about before getting this screening done. There is a new study out which specifically addresses the fact that CTA technology is challenged by the bodies of obese patients.

"Obese patients have specific challenges: They have multiple risk factors and comorbidities, they are difficult to assess clinically, and ... also it's not so easy to peform conventional angiography due to their body constitution," he said. "It would be nice if CT had some role in the evaluation of these pateints' coronary arteries."

This is a particular conundrum because of the fact that obese patients are more prone to risk of heart disease and stroke than are their normal-weight counterparts. As such, this type of screening is even more important to this population and yet it may be less effective or less useful for this population. Researchers are interested in finding ways to improve screening technology of this kind so that it can be used with a wider range of the population.

Question of the Day: Who do you think should be responsible for making changes in this area of technology?

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Tuesday, March 11, 2008
Brain Scans Read Minds with 90%+ Accuracy
At the beginning of this year, we reported on a study which revealed that MRI scans are being tested out as mind-reading devices. You can read the report on that here but basically it showed that brain scans can read the patterns of a person's brain when they are viewing a particular item and then know which item the brain is thinking about when that pattern comes up again. A new study shows that the potential for brain scans as mind-reading machines may be even bigger than the original studies indicated.

The major difference between the new study and the previous study was that the original study used pictures that the study subjects hjad already seen while the new study used pictures that were unseen by the study subjects. This speaks to the fact that this technology might have the ability to read the patterns in the mind with less specific rigidity in the parameters of the study than previuosly suspected.

The study showed that a computer could guess what was in the mind of the study subject with over ninety percent accuracy in some cases. Considering that just a plain old guess by a human would result in less than one percent of a correct answer, this indicates that technology has made a big leap in the arena of mind reading.

So what? You might think that this information is only good for a fun conversation topic at parties but it turns out that there are some important medical implications as well. For example, it has been suggested that this could ultimately be used to create technology that would allow quadriplegics to use their minds to communicate commands to a computer which could then assist them in their daily tasks.

Question of the Day: What do you make about these studies of brain scans as mind reading machines?

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Monday, March 10, 2008
Scanning for Stroke Prevention
One of the biggest health concerns facing Americans today is the risk of a stroke. In order to prevent a stroke, people often turn towards imaging technology that is designed to check for blockages in the arteries. There are several different options for getting a carotid artery scan including an ultrasound and an MRI. However the most common method of scanning for blockages is through the use of a CT angiography.

Computerized tomographic angiography, also called CT angiography (CTA), is a radiological test that combines the technology of a conventional CT scan with that of traditional angiography to create detailed images of the blood vessels in the body. It uses X-ray technology to check out what's going on in the body so that doctors can identify problem areas and assist you in reducing the likelihood that you will suffer from a stroke.

However, there have been some concerns about the levels of radiation that are fiven off during the use of the CTA. This is complicated by the fact that there are different types of CTA scanning machines which may deliver different levels of radiation.

"There are conflicting reports regarding the radiation doses delivered by 64-slice CT and dual-source CT -- especially concerning an increasingly common application with a worrisome dose profile: retrospectively gated coronary CT angiography (CTA)." (source)

Studies have recently revealed that the difference between the two types of scanning technology in regards to the level of radiation are probably more dependent on the patient than on the technology itself. The patient's heart rate seems to be a bigger factor in the levels of radiation than does the type of scanning machine used. Essentially, someone with a lower heart rate can use either kind of scan but someone with a higher heart rate will want to use the dual-source CT.

Question of the Day: What questions would you ask your doctor before getting a CTA to prevent strokes?

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Friday, March 07, 2008
Brain Scans Give Insight into Anorexia
We normally think of MRI brain scans as being used for medical situations requiring immediate attention to the brain. If you are having symptoms that suggest that you might have a brain tumor (obviously a highly serious condition) then your doctor might recommend checking it out with a brain scan. Likewise, brain scans may be used to detect strokes and determine treatment for them.

However, brain scans are also used in a wide range of medical studies that provide information about all sorts of different medical issues. These may not be immediate problems that require that you look at an individual's brain. However, using brain scans to review the brains of individuals affected by a certain problem can provide insight into ways to diagnose, prevent and treat a variety of medical conditions.

For example, brain scans may be used to study a population such as those people suffering from anorexia. A recent study of this nature revealed information about the anorexic brain which showed that these people can't tell the difference between winning and losing. This information can greatly assist in the treatment of a widespread problem such as anorexia. (Learn more here.)

Question of the Day: Do you think brain scans are used more often to treat individuals or to study conditions?

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Thursday, March 06, 2008
Books about the MRI
The main resource that you're going to turn to when seeking out information about MRI scans is, of course, your doctor. However, you should also get information from all sorts of other sources so that you can make sure you know everything about the topic that you want to know. News articles, blog posts and other written resources are terrific for getting this kind of basic information.

If it's more in-depth information that you're seeking, here are some books about the MRI that you might consider looking at more closely:

- The Essential Physics of Medical Imaging (2nd Edition)

- MRI in Practice (3rd Edition)

- Breast MRI: Diagnosis and Intervention

- MRI Guide for Technologists: A Step by Step Approach

- Body MRI

- Questions and Answers in Magnetic Resonance Imaging

- Lippincott's Magnetic Resonance Imaging Review

There are many books available about preventive imaging and health care. Start reading in order to gain the kind of complete knowledge that can help you stay healthy for a long time to come.

Question of the Day: What other books can you recommend for reading about the MRI specifically or preventive imaging in general?

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Wednesday, March 05, 2008
Strong Women, Strong Medicine
A news report earlier this week profiled the work of two strong women. The two women formed DeCesaris-Prout Cancer Foundation which raises money towards cancer prevention and research. This money has gone to a variety of large and small organizations including the work of the American Cancer Society.

This alone is something to write home about. These women didn't have to set up such an organization or contribute so much to the cause. But it is the personal stories driving these women that really speak to the power they exhibit. These are stories which have driven them to the work that they're doing but also which speaks to the strength that has helped them survive through difficult times.

For example, one of the women had a series of medical problems that she was concerned might be ovarian cancer. She went to her doctor who told her that she basically had a weight problem and that she would be fine. Instead of just taking the word of her doctor, she insisted that a CT scan be done. Indeed, it was found that she had cancer. This is the cause behind her support of cancer research but also speaks to the power of her own personality.

Question of the Day: Would you take a doctor's diagnosis such as this one at face value or insist on a preventive scan?

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Tuesday, March 04, 2008
Brain Scans in the Courtroom
A recent online article pointed out the fact that medicine and law aren't as far apart these days as they might have been in the past. More specifically, the article looks at how brain scans are being used in court cases as indicators of different aspects of the crime under trial. For example, a brain scan may be used in a criminal case to show that the defendant likely suffers from a medical disease that impaired his or her judgment in the situation leading to the trial.

It has been suggested that brain scans may also be used to determine whether or not someone is suffering from physical pain elsewhere in the body. If this aspect of imaging does indeed develop, it would be possible for personal injury lawyers to make use of brain scans to show that individuals claiming injury are indeed suffering from pain in the body.

There are many different things that hinder the development of using brain scans in the courtroom. Most importantly, the technology that imaging doctors are so familiar with isn't commonly understood by the average jury member. However, we are seeing an increasing number of cases in which brain scans may be used to make or break a case in the courtroom.

Next thing you know we'll be using MRIs as lie detectors!

Question of the Day: Do you approve of the use of brain scans in proving or disproving information presented in criminal trials?

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Monday, March 03, 2008
Lower Your Chance of Having Appendix Removed with CT Scan
Do you know someone that had his or her appendix removed? Perhaps you've even had it done yourself. This is a fairly common procedure that has been done on a diverse range of patients over the years. However, removal of the appendix is on the decline and that is believed to be due in part to the fact that it may not be as necessary to remove it as doctors once thought. Doctors who use a CT scan to determine whether or not the appendix must be removed frequently realize that it doesn't. In contrast, doctors who don't use the CT scan are more likely to recommend appendix removal that isn't necessary.

This information comes from a medical research study completed in Los Angeles. The doctors showed that the unneccesary removal of the apendix decreased significantly after CT scans began to be used for this procedure. Prior to their use, approximately one in four people who got their appendix removed probably didn't need to do so. Since CT scans are now used for this procedure, less than three percent of removals are deemed unnecessary.

Question of the Day: Would you encourage your doctor to use a CT scan if he or she thought that your appendix needed to be removed?

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