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The Obama Administration placed strong backing for electronic medical record (EMR) development by making federal funds available to doctors that implement EMR systems. Under the American Recovery and Reinvestment Act [...]

Mammography is an X-ray technique that is used to detect breast cancer. It is highly recommended that women undergo regular screening for breast cancer by mammography. However, many physicians do not encourage breast cancer screening. Most women seem reluctant to have mammograms because of fear of radiation exposure or not seeing the value of the radiologic examination when no symptoms are present. Economic and time constraints are also a hindrance. Mobile screening units, which may be sponsored by employers and brought to the workplace, can remove some of these barriers. This study examined the results of a corporate-sponsored program of breast cancer screening. A large corporation in Pennsylvania and Delaware sponsored a statewide breast cancer screening program for its female employees and the wives of male employees. The women were charged $30, less than half the actual cost; the corporation paid the remainder. A total of 3,627 women had mammography performed through the program. Of these women, biopsies were recommended in 63 women (1.7 percent); of the 57 biopsies actually performed, breast cancer was diagnosed in 9 women. In 8 of the 9 cases, no symptoms of breast cancer were present, and 7 of the cancers were in early stages. Eight of the women were more than 40 years of age. The 1.7 percent biopsy recommendation rate was lower than the 3 percent rate reported nationally; this finding was attributed to the large number of younger women in this study. The costs to the employer were calculated to be $78,343, which was less than the cost of female employees taking two hours away from work to go elsewhere for mammography. These results indicate that work site mobile screening programs for breast cancer can be less expensive for employers and encourage greater participation among women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Magnetic resonance spectroscopy (MR) is a technique by which the levels of a particular compound can be measured based on its unique magnetic properties. It is a potentially valuable tool for medical testing since it can be used to gain biochemical knowledge within tissues of the body without having to disturb the tissues. One major problem has been developing MR techniques that can compare biochemical data from different areas within the tissue being studied. Phosphorus-31 (P-31) MR measures phosphorus metabolism in tissues. This is an important measurement in studying brain tumors. One common technique used now for such measurements is image-selected in vivo spectroscopy (ISIS), which can measure data from a single voxel (a minimal three-dimensional picture element) in a given tissue, thus limiting the ability to make comparisons with other areas within the tissue. A newly developed technique, known as three-dimensional chemical shift imaging, is examined in this study. It can measure data from up to 1,152 voxels (of virtually any polygonic shape) at the same time, thus allowing for comparisons from different areas within the tissue being examined. Six volunteers were studied using this experimental technique to measure P-31 metabolism in their brains. Axial (through the width), sagittal (lengthwise to split in half) and coronal (split front to back) planes were examined. The data was also compared to corresponding data using hydrogen-1 MR to test how well the P-31 data corresponded to the actual anatomy from which it was obtained. Results indicated that this technique resulted in good quality images that demonstrated clearly defined areas of the brain and that correlated excellently with the anatomy from which they were obtained. These results indicate that 3-D chemical shift imaging has great potential as a technique to measure P-31 metabolism within different areas of a given tissue or tissues at the same time and could be of great use in examinations of the brain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Although breast cancer-related deaths can be cut by as much as 35 percent by early detection with routine mammogram examination, fewer than 20 percent of all women over the age of fifty have had a mammogram. The percentage of women who have regular mammograms is even lower. The rate of women having mammograms has been reported as increasing, but the level is still surprisingly low in relation to the potential reduction in mortality. A number of patient-related variables have been identified that provide barriers to women who should undergo this procedure. In this study 600 women were interviewed who were offered a free mammographic examination. A statistically significant number of women who did not take advantage of the offer held the belief that a mammography is unnecessary without breast-related symptoms and, in any case, is inconvenient. A woman whose doctor considers mammography important is more likely to accept the procedure. In order to further reduce barriers to women obtaining mammograms, the cost of the procedure should be reduced and reimbursement mechanisms should be changed. Mammography should be made widely available to women, and physicians must remind women of the need for routine breast examination by this method.

The author reflects on the evolution of radiology practice in the U.S. He stresses that young radiologists are beginning to seek for alternative opportunities which revolve around autonomy, lifestyle changes and desire to work outside the traditional group practice. This scenario has been described by the author as a restructuring of the industry through enabling technology and by innovation at hand.