Health Imaging & IT - February 2008 - (Page 42)

The World’s Largest Scientific Meeting and Exposition Focusing Exclusively on Telemedicine ATA 2008 SeattleWashingtonUSA 6-8 April 2008 300 Presentations and Posters 2000 Attendees 100,000 Square Feet of Exhibit Space to increase access to virtual colonography and could lead to coverage through a National Coverage Decision (NCD). Regardless of the route, the writing is on the wall. Virtual colonography reimbursement should improve in the next 12 to 18 months. “The potential [virtual colonoscopy market] is huge. In the next 10 years, as many as 50 million Americans may need the exam,” notes Kim. Smart providers should get ready. laying the groundwork Providers eyeing the virtual colonography market need to consider multiple factors as they prep for 2009 and beyond. “Training is the most important step a practice can take; readers need to develop facile skills with 2D and 3D image display review of datasets in the 800 to 1,000 image data range,” says McFarland. Training should cover both physicians new to virtual colonoscopy techniques and early adopters as more recent techniques have evolved in the last five years. For example, five years ago, virtual colonography studies did not tag stool, but today stool is tagged with barium or iodinated contrast. Interested radiologists can find multiple training courses across the country via various professional societies, individual university programs and at a state-of-the-art on campus ACR training facility. The new ACR program opening in March pairs novel training software and various vendors’ 3D workstations to expose readers to different size and shapes of polyps, with individual tailored feedback. ACR practice guidelines deem a reader qualified after he or she interprets 50 colonoscopy-proven virtual colonoscopy studies. Another major ingredient is technology. CT colonography requires a 16-slice or higher CT scanner, PACS and post-processing solution able to handle large datasets. Options include Barco Voxar 3D ColonMetrix, GE Healthcare CT Colonography Applications Package, TeraRecon Aquarius Workstation, Viatronix V3D-Colon and Vital Images Vitrea. Strong integration between the advanced visualization solution and PACS can benefit the practice as well by streamlining workflow. Colon CAD is another promising development, says Kim. Tools such as Medicsight’s ColonCAD software and Siemens Medical Solutions syngo Colonography PEV can help inexperienced readers detect lesions. Anno Graser, MD, lead researcher of abdominal imaging at University of Munich in Germany, adds to the CT colonography prerequisite list. Sites that want to establish a virtual colonography program should establish a solid patient protocol to provide reproducible quality data. An automated insuflator that uses carbon dioxide rather than room air provides better distension of the colon, says Graser. Finally, double reading or CAD can be worthwhile. “In the beginning, even experienced radiologists will miss lesions,” notes Graser. Solutions like Siemens syngo Colonography PEV accurately detect polyps in the 6 to 25 mm range and readily integrate into the review process. To date, virtual colonography can’t detect polyps smaller than 5 to 7 mm. Yee recommends sites designate a virtual colonography program leader to oversee the implementation from training to referring physiHealthImaging.com American Telemedicine Association www.americantelemed.org 42 Health Imaging & IT | February 2008 http://www.americantelemed.org http://HealthImaging.com

Table of Contents Feed for the Digital Edition of Health Imaging & IT - February 2008

Health Imaging & IT - February 2008 Contents On the Web The Enterprise News Update Cover Story: Enterprise Image Management Makes the Grade Modality Update Special Section: Health IT: Image Management Special Section: Health IT: PCs on the Move Convention Spotlight Technology Outlook Technology Update Reader's Resource Stat Sheet

Health Imaging & IT - February 2008

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