Tales from RSNA

By Sandy Mueller, BA, RT(R)(M), RDMS

Posted on: December 13, 2010

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Did you make it to RSNA this year? (That's the big annual conference and expo from the Radiologic Society of North America, for those of you who've never been!) I live only about 25 miles from the meeting center, so I am able to get there and press my nose against the window, drooling at all the beautiful new equipment I can't afford. This is where all the vendors trot out their latest and greatest--it's so competitive that some technology is under lock and key; you have to have a special escort to see it! My friend Lester calls it "RSNA--you know, Real Stuff Not Available."

I saw some fascinating developments for breast imaging, like tomosynthesis (tomo for short). Some of the vendors have been working on it for a few years now, but it's finally looking like it's about to be FDA-approved for use in the U.S. What's tomo, you ask? (You did ask, right?) Well, it's sort of like a CT of the breast, but done on the mammography machine. The tube swings and takes nine to15 exposures per swing, depending on vendor. The images help determine location, size and borders of lesions.

It also generates some questions. It's being touted as both a screening and diagnostic tool. But will yet another diagnostic tool help, or just muddy the waters? Will patients with abnormalities end up getting a mammo, ultrasound, tomo, MRI and nuclear study? Where do we draw the line? As for screening, it sounds great. But how will we get costs low enough? With health care reform, reimbursements are likely to go down, not up, a theme generally echoed at the RSNA this year.

I also saw closed MRI scanners that are so "open" you don't need an alternative for claustrophobic patients. Does this mean the end of open MRI? Or will open MRI continue to raise its quality to equal closed units?

I also had a visit with gamma cameras (breast specific gamma imaging, or BSGI) and PEM scanners (PET for breast). These were very advanced diagnostic and staging tools. Oh, and ultrasound machines that showed both planes, side-by-side, for localization.

Pretty amazing stuff. What struck me most was this: with technology moving so quickly, medical imaging equipment is becoming like our TVs, PCs and cell phones: the moment you take it out of the box, it's outdated. So I predict (remember, you heard it here first) a shift in how equipment is acquired--instead of buying, we'll lease. And we'll write upgrades into the contract. Vendors, are you listening?

Sandy Mueller, BA, RT(R)(M), RDMS, is the technical manager of Adventist Hinsdale Hospital's Outpatient Imaging Centers in Hinsdale, Ill.

Mammo-Gram Archives

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