As we mark the close of day three of the 2010 Radiological Society of North America (RSNA) Scientific Assembly and Annual Meeting, it is highly apparent innovation is not slowing for imaging technologies. Today we saw not only some new technologies from vendors, but also, overall improvements to existing technologies which will render them safer, more effective, and more efficient. As Atul Gawande and former President Bill Clinton addressed during keynote sessions today, radiologists have the unique opportunity to greatly inflect the future of healthcare delivery through continued innovation, both in medical and information technologies. Here, we present a few of our big takeaways from day three of the 2010 RSNA.
2010 RSNA Day 3 - New Innovations Driving Substantial Dose Reduction Opportunities
I recently attended a symposium on prostate cancer treatment hosted by Memorial Sloan Kettering Cancer Center. The speaker--a urologist and co-director of the MSKCC robotic surgery program--presented some intriguing information about the history of their prostate cancer program and how the role of robotic surgery has evolved over the years. MSKCC has seen dramatic growth in robotic radical prostatectomy volumes over the past decade. However, the growth they have seen has largely been fueled by later stage, more advanced prostate cancer cases. As robotic prostatectomy volumes have increased, the proportion of patients treated for early stage prostate cancer within the program has actually fallen substantially. This is intriguing because one of the major drivers of growth in prostate cancer treatments on a national level has been the increased use of PSA testing, which was rolled out as a cancer screening method over two decades ago and has driven an uptick in the number of prostate cancer cases diagnosed each year. While this test clearly enables diagnosis of all stages of prostate cancer, it has unearthed a massive population of men with early stage prostate cancer who arguably would not have otherwise been diagnosed as early--if at all.
Compared to many programs, where conventional wisdom holds that the increase in early stage prostate cancer diagnoses--combined with a growing number of trained and interested urologists--has driven more use of robotic surgery, the MSKCC program has seen growth in the face of an intensified focus on the watchful waiting approach for early stage prostate cancer patients. While patient choice is the ultimate deciding factor, the statistics from MSKCC's program indicate that a systematic and deliberate focus on watchful waiting has actually shifted their paradigm for management of early stage prostate cancer, while also supporting a robotic surgery program for potentially more necessary cases.
With prostate cancer treatment in the limelight of comparative effectiveness research efforts and broader cost-conscious scrutiny of healthcare expenditures, the future for robotic surgery is subject to a great deal of turbulence. This program provides an interesting case example of a cancer center that is clearly merging a devotion to innovation with a realistic acceptance of evidence based, conservative medicine.
Today marks Technology Insights' second day of coverage from the 2010 Radiological Society of North America (RSNA) Scientific Assembly and Annual Meeting. It was an exciting day as new research was presented exploring the near-term and long-term prospects of myriad imaging modalities, including neurological and oncologic imaging with MRI, PET, and the two combined in a hybrid modality. Also, more details continue to emerge regarding functional breast imaging modalities, as evidence is accumulating validating their role in the breast cancer continuum. Additionally, after meeting with several vendors (and many more yet to come!), several new technologies are preparing for 2011 commercial availability.
2010 RSNA Day 2 - Oncologic, Neuroimaging Taking Center Stage with New Cutting-Edge Technologies