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Radiographic and fluoroscopic: what's new?

by Lisa Chamoff, Contributing Reporter | November 22, 2016
X-Ray
From the November 2016 issue of HealthCare Business News magazine

“We found that everyone wanted our radiographic and RF equipment and everyone had different CR or DR systems in their hospitals,” says Serrao. “We said, ‘Why sell panels from only one OEM?’ “ For Shimadzu’s latest SONIALVISION G4, the R/F system offers both tomosynthesis and slot radiography as options.

Dr. David Zadvinskis, medical director of the radiology department at OhioHealth Dublin Methodist Hospital in Dublin, Ohio, says the facility is in the process of purchasing a Shimadzu G4, currently in use at Riverside Radiology and Interventional Associates, where Zadvinskis also practices. What drew them to the product was the 750-pound weight limit for the table, which can also go down to 18 inches, the ability to do exams for non-mobile patients while they’re propped up in bed and the tomosynthesis capability, Zadvinskis says. The facility will also take advantage of the slot radiography for scoliosis surveys. Tomosynthesis is a good exam for fractures and a replacement for expensive CT scans.

“Instead of having a single image, when you have tomosynthesis, you can go through a millimeter at a time and see a fracture easily,” Zadvinskis says. “I believe tomosynthesis may become an important modality in the setting of fracture evaluation.”
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GE Healthcare
While GE is waiting for RSNA to release information about its new products, the company is excited about a recent development in digital X-ray tomosynthesis, which provides a stack of X-ray images reconstructed into slices, removing the hindrances in imaging of overlapping anatomical structures. Studies have shown, for example, that digital X-ray tomosynthesis can detect small-size lung nodules, 4 to 6 millimeters in diameter, at 7.5 times the sensitivity, with no loss of specificity compared to a two-view chest X-ray. GE provides it in an advanced application called VolumeRAD, available on GE’s premium fixed X-ray systems, including the current Discovery XR 656 Plus platform, which was launched last year.

Michelle Edler, general manager of the global X-ray business at GE, says that while digital X-ray tomosynthesis is gaining traction, there is a hesitancy to use it because there is no specific Current Procedural Terminology (CPT) code. GE has engaged with the American College of Radiology (ACR), which has recommended applying for a dedicated code. In the interim, the ACR recommends using the CPT 76100 code to report X-ray tomosynthesis, Edler says. CPT 76100 is for radiological exams with a single-plane body section and was used for an older technology called linear tomography. Providers who report code 76100 for tomosynthesis may be reimbursed by payers.

“It’s a step in the right direction to compensate physicians for reading the multiple slices of a typical digital tomosynthesis exam,” Edler says. “To really drive and accelerate adoption, the reimbursement has to catch up with the technology.” The technology can help visualize complex joint spaces more clearly, Edler says, and the company has been working with the orthopedic surgical community. “We’re getting a lot of traction when it comes to the orthopedic space,” Edler says.

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