Alyssa Pollizzi and Rachel Klein
In February 2011, the FDA approved tomosynthesis as a breast cancer screening and diagnostic tool. Unlike traditional 2D mammography, DBT captures multiple images from the breast and reconstructs them to form a 3D image.
Fast forward to 2013. Clinical evidence has yet to convince the radiology community that the higher cost of the tomo system, longer radiologist read time, and additional radiation dosage is worth it. Practitioners also wonder which population this technology is best suited for - Screening? Diagnostic? Dense breasted women? A firm answer isn't available.
Tomo on the rise: DBT shows improvement in screening setting
Angiogenesis inhibitors, such as Avastin, are some of the most exciting tumor-killing drugs to emerge recently. As tumors grow larger than a few millimeters, they consume more resources and require an increased blood supply. Tumors use growth factors such as VEGF to stimulate vascular growth, or angiogenesis, to redirect blood for continued growth or metastasis. Angiogenesis inhibitors interfere with VEGF, essentially starving the tumor.
DCE-MRI: Old technique, new applications
In the latest American Journal of Roentgenology, new research emerged touting follow-up protocols for CT lung cancer screening, marking the latest in a series of developments that have pushed screening into the forefront of administrative planning discussions. Other major developments were a National Lung Screening Trial (NLST) displaying mortality reduction of 20% among high-risk patients screened for lung cancer, as well as a substantial increase in CMS reimbursement for Bronchoscopy with Fiducial Markers (CPT 31626) from $723 in 2011 to $2,024 in 2012.
This collection of new tools, evidence, and reimbursement has sparked substantial interest by our hospital membership in developing lung cancer screening programs. However, the decision is not a no-brainer, and many considerations on timing, methods, and technology are required before proceeding with program development.
Lung cancer screening programs—is now the right time?