Radiology

Although I have posted a number of previous notes about the potential merger of pathology and lab medicine with radiology, I strongly believe that such a change must be preceded by a much tighter integration of clinical pathology (CP) and anatomic pathology (AP). Part of the value of the proposed merger for radiologists will be the ready availability of a total view of disease based on both molecular diagnostics and morphologic observations coming from the pathologists. As I have noted... Read Full Story

The shift from film to digital mammography is occurring rapidly, resulting in diagnostic images with higher resolution and higher fees. It's also causing a greater number of patient recalls. These facts were revealed in a recent article in the New York Times (see: In Shift to Digital, More Repeat Mammograms). On the right is a graph from the article illustrating the adoption rate of this new technology from 2004-2007. Many patients are unaware of this shift in imaging technology but some... Read Full Story

In a recent post (see: Reinventing the Autopsy: CT Imaging as a Routine Part of the Procedure), I suggested that this may be the right time to begin to reinvent the autopsy. In particular, I believe that a whole-body CT scan should be a mandatory first step in all such procedures. At the beginning of this note, I cited Dr. Jared Schwartz as the individual who had stimulated my interest in integrating imaging techniques such as the CT scan into the standard autopsy. He has posted a comment to... Read Full Story

A remark by Dr. Jared Schwartz during a lecture at the Futurescape Conference last June caused me to reflect on the possibility of reinventing the classic autopsy. At that time, he remarked that his department had installed an older model CT scanner in the autopsy room at Presbyterian Hospital in Charlotte, North Carolina. Pathologists in his department were using CT scans to supplement and enhance their autopsy findings. Germane to this same point, Dr. Michael Feldman noted in his lecture at... Read Full Story

It has been suggested that one of the reasons that Siemens and GE have acquired a number of IVD companies lately, thereby extending their reach in diagnostic medicine, is that demand for medical imaging equipment is softening. Their hedge has been prompted, in part, because insurance companies and Medicare are taking a harder look at the rising cost of imaging procedures. A recent article (see: Cranking Up the Volume) addressed this issue. Below is an excerpt from it with boldface emphasis... Read Full Story

The trend toward new subspecialties in medical training, often at the fellowship level, seems to be inexorable. In recent years, to mention a few, we have seen the emergence of interventional radiology, feto-maternal medicine, emergency medicine, and sports medicine. There are even ultrasound fellowships within emergency medicine (see: Additional Discussion About "Radiology Without Walls"). At the recent Molecular Summit conference that was held in Philadelphia, Dr. Aaron Baggish of the... Read Full Story

A recent article published on the web indicated that pathology services in Johannesburg, South Africa, are on the verge of collapse (see: Joburg pathology services collapsing). Below is an excerpt from it with boldface emphasis mine:State pathology services in Johannesburg are on the brink of collapse, posing a threat to thousands of patients. By the end of May only four anatomical pathologists - responsible for diagnosing cancer among state patients - will be left at the Johannesburg branch... Read Full Story