Some costing info on the various imagers:
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Breast Cancer Diagnosis
Sept. 22, 1997
Finding a lump in your breast can be a devastating experience. But what follows in the diagnostic process can be just as daunting.
Dr. Tim Johnson explained for GMA viewers the standard diagnostic options presently available-from mammography to MRI to biopsy procedures.
There are also some truly remarkable new diagnostic techniques currently in clinical trials:
LASER MAMMOGRAPHY:
Approved in 1996 by the FDA for widespread testing, this imaging device is known as Computed Tomography Laser Mammography. Rather than using radiation to see inside a woman's breast, it relies on harmless pulses of laser light to identify tumors. The image is as clear as an MRI but takes 1/6 the time and costs 1/10 of the price. Apparently, it can also image dense young breasts and it can see through and around implants. It is still in clinical trials.
THE PET SYSTEM:
Positron Emission Tomography, or PET for short, could make traditional biopsies a thing of the past. PET gives doctors a remarkable image of the breast and surrounding area and tells them far more about the size and location of tumors than every before. The technology allows physicians to know how big and how invasive a cancer is before a patient ever goes under the knife. Knowing the extent to which the cancer has developed helps in knowing whether a mastectomy is necessary or if a lumpectomy will be enough. Patients are injected with a harmless compound designed to react to the radiation emitted from the PET scanner. If a tumor is present, the compound draws attention to the cells in this area. The PET converts the data into a 3-D image (as opposed to mammography's 2-D image) that not only identifies the tumor but shows all surrounding tissue. It can indicate if a tumor is benign or malignant and can reveal if the cancer has spread (because it scans the whole body.)
ONE STEP LUMPECTOMY:
ABBI or Automated Breast Biopsy Instrumentation is like a computerized cookie cutter. Putting a new spin on stereotactic needle biopsy, (which combines mammogram with tumor analysis) the ABBI locates a breast lump and removes it, all in one step (provided the lump is less than 2 cm in diameter.)
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An Effective Cancer Scan
Expensive But Can Avoid Some Pricey Surgeries
By Matthew Fordahl
The Associated Press
L O S A N G E L E S, June 8 — A medical scanner once rarely used because of its high cost and difficulty can detect cancerous tumors missed by other imaging devices, researchers say.
Studies show that positron emission tomography, or PET scans, can lead to fewer surgeries and biopsies for cancer patients. The technology also could help doctors more accurately diagnose heart disease and brain disorders.
The findings were presented Monday at the Society of Nuclear Medicine conference, where about 40 percent of the studies were related to PET.
“The message is that PET has arrived,” said Edward Coleman, professor of radiology at Duke University. “PET is now having a major impact in the way we are taking care of patients.”
CT Scanners Use X-Rays
Traditional techniques, such as computed tomography scanning, or CT, measure internal body forms — whether a tumor is present, for example. CT scanners use computers to combine X-rays of the body.
But patients who undergo PET scans are injected with sugar that is labeled with signal-emitting tracers. The scanner records the radioactive tracers as they travel through the body and collect in various organs. A computer then reassembles the images, which show organ function — and failure.
“Tumors really like sugar, or glucose, better than the surrounding tissue,” said Alan Waxman, director of nuclear medicine and co-director of imaging at Cedars-Sinai Medical Center. “You can actually see the concentration in a tumor at a far greater level than the surrounding tissue.”
Studies show the course of treatment — including a reduction in surgeries and biopsies — is often changed for cancer patients after a PET scan.
Helps Avoid Major Surgeries
Ongoing research at the University of California, Los Angeles has found that major surgery was avoided in about 25 percent of the dozen patients studied so far. It shows that PET scanning can be cost-effective, Coleman said.
In cases of malignant lymphoma, or cancer of the lymph nodes, PET scanning was 96 percent accurate in detecting tumors compared with 64 percent with CT scans, said Inga Buchmann, researcher at University Hospital in Ulm, Germany.
Both CT and PET scans have been around since the 1970s. PET scans were often expensive and difficult because the radioactive injections could be created only with an expensive compound and were effective only for a few hours.
Procedure's Use Expands
In 1997, only about 50 centers in the United States offered the procedure, mostly university research hospitals. This year, the number has increased to about 300 nationwide, Coleman said.
Medicare started paying for the treatment for patients who suffer from some forms of lung cancer in January. Coverage will be expanded next month to cover patients with colon-rectal cancer, lymphoma and melanoma.
PET equipment remains a sizable investment for any hospital, costing as much as $1.8 million. A San Diego company has created a mobile version of the machine and contracts with several Southern California hospitals for its services.
“The hospitals use it once or twice a week, and our company maintains the upgrades,” said Paul Crowe, chief executive officer of Mobile PET. “What we do here is fulfill the business needs as well as the medical staffs' needs and create a win-win for everybody.”
The average cost per patient is about $1,300, he said.
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(GE's new device will not be any cheaper than the PET.)
GE develops new medical imaging technology
LOS ANGELES, June 7 (Reuters) - GE Medical Systems said on Monday it had developed a better way to identify health problems and diseases by combining X-rays and radioactive tracers injected into the body. 'This technology is a major breakthrough in nuclear medicine that will improve patient care over the next several years,' Dr. Edward Coleman, professor of radiology at Duke University Medical Center, told reporters at the Society of Nuclear Medicine's annual meeting. The technique, known as functional anatomic mapping, will help to lower overall health care costs since doctors will have a clearer picture of which surgery or therapy is needed, according to GE Medical, a unit of General Electric Co. < >GE.N> that makes medical diagnostic equipment and services. The technology will improve the ability of doctors to accurately diagnose patients. It merges the ability of nuclear medicine to show the functioning of internal organs with the anatomical images of digital X-rays. Nuclear imaging is done by injecting short-lived radioactive drugs into a patient's bloodstream, and using a nuclear camera to, in effect, take a time-exposure 'photograph' of the drug as it enters and concentrates in tissues or organs. By so doing, doctors can learn about the biological activity of the organ or the vascular system that nourishes it. Nuclear medicine is used to diagnose cancer, study heart disease and circulatory problems and to detect kidney malfunction or other abnormalities in veins, tissues and organs. 'Functional anatomic mapping technology utilizes standard nuclear medicine imaging techniques to form a resultant image that is a perfect combination of anatomy and physiology -- this is a significant departure from how we review images today,' said Beth Klein, general manager of GE's global nuclear medicine business. To obtain the new mapping images, a patient is put on a table, just like in a nuclear medicine or PET (positron emission tomography) exam. A digital X-ray is carried out, followed immediately by the nuclear medicine exam, which is done with a specially-designed revolving detector. 'Knowing the precise location of the disease, monitoring the response to therapy, and differentiating non-invasively benign from malignant lesions is critical to good patient care,' said Dr. Martin Sandler, professor of radiology and medicine at Vanderbilt University, which is conducting clinical trials with the mapping technology. The technology, which is under review by the U.S. Food and Drug Administration, will likely be commercially available during the year 2000, GE said. |
