CT artifact-reduction software gets put through its paces

August 25, 2016

Aug 17, 2016 | Dave Pearson

An independent review of four CT vendors’ metal artifact-reduction (MAR) solutions has shown that all four appreciably improve image quality. However, the reviewers noted additional artifacts and degradation of image quality, leading them to recommend carefully evaluating each software package’s algorithm case by case in clinical practice.

In a study running in the August edition of the British Journal of Radiology, Karin Andersson, MSc, of Örebro University in Sweden and colleagues describe their work using the various MAR techniques to image a phantom simulating a patient with bilateral hip implants.

The team imaged the phantom on Philips’s Ingenuity Core system, Toshiba’s Aquilion One Vision Edition, GE’s Discovery 750HD and Siemens’s Somatom Definition Flash.

In addition to acquiring CT images with the specific MAR technique available with each respective scanner, they also acquired 120-kVp CT images—aka “uncorrected images”—without using any MAR technique on each scanner.

They further obtained images using MAR algorithms for single-energy CT data or dual-energy CT (DECT) data and by monoenergetic reconstructions of DECT data. These data were visually graded by five radiologists using 10 image-quality criteria.

The reviewers’ key findings:

The MAR algorithms, in general, improved the image quality based on the majority of the criteria with a statistical improvement in overall image quality.
Degradation of image quality, such as new artifacts, was seen in some cases.
A few monoenergetic reconstruction series improved the image quality for one of the DECT scanners, but it was only improved for some of the criteria.
Monoenergetic reconstructions resulted in worse image quality for the majority of the criteria for the other DECT scanner.

On the last point, the researchers concluded that, in general, monoenergetic reconstructions are insufficient for reducing metal artefacts.

In their study report, the authors summarize the scan parameters for each CT machine. The journal posted the paper online for its subscribers earlier this year and is now offering it to all for free.

CLICK HERE to download the paper for free.

Bon Secours says data breach affects 655,000 patients

August 24, 2016
Reimbursement specialist R-C Healthcare Management, a business associate under HIPAA, left patient information accessible on the web for four days.
By Mike Miliard

11:11 AM
 Personal information of more than 650,000 Bon Secours patients – including names, insurance identification numbers, banking information, social security numbers and some clinical data – was left exposed on the internet for four days this spring by a business associate of the hospital system.

R-C Healthcare Management, a reimbursement optimization firm, was adjusting its network settings between April 18 and April 21, and in doing so exposed data of Bon Secours patients in three states – 435,000 of them Virginia, and the rest in South Carolina and Kentucky – to be accessible online.

Bon Secours first discovered the vulnerability on June 14 and, in turn, notified R-C Healthcare.

“Upon receiving the notification, R-C Healthcare immediately took steps to secure the information so that it could no longer be accessed via the internet,” according to a statement.

R-C Healthcare CEO K. Michael Webdale told Norfolk, Virginia-based WTKR that the company promptly hired an outside forensic investigator.

“The investigator confirmed the incident has been fully remediated. All R-C customers who might be affected have been notified of the situation and its resolution. ”

Bon Secours also kicked off an internal investigation ands found that the files R-C made available via the internet may have exposed patient names, social security numbers, bank account information and limited clinical data.

“Medical records were not made available via the internet and medical care has not and will not be affected,” the health system said.

Bon Secours officials said it took nearly two months to for an internal investigation to identify the patients who should be notified. The health system began mailing letters to those affected on August 12.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

Fight to repeal North Carolina’s CON marches on — 5 insights on the state with one of the most restrictive CON laws

August 23, 2016

 To repeal North Carolina’s controversial certificate-of-need legislation, Sen. Ralph Hise (R-Mitchell) added a CON repeal proposal to House Bill 161, “An Act Adopting the Bobcat as the Official State Cat of the State of North Carolina,” according to The Heartland Institute.

Here are five insights:

1. The state legislator ended its session on July 1 without approving the bill featuring the CON repeal.

2. Katherine Restrepo, a health and human services policy analyst at the John Locke Foundation, argued the state’s CON law for ambulatory surgery centers has costly repercussions for patients and insurers. The CON law poses challenges for patients to obtain cost-effective, convenient healthcare services.

3. To illustrate her point, Ms. Restrepo said surgeons perform 70 percent of outpatient surgeries in a full-hospital setting in the state, which cost patients and the healthcare system between 40 percent and 65 percent more than performing those procedures in ASCs.

4. Thomas Stratmann, PhD, an economics professor at George Mason University in Fairfax, Va., said repealing the CON laws would give patients more treatment options, thereby improving quality of care. He said, “We would observe higher quality care, because with repeal, and subsequent entry—more medical providers offering services—there will be more competition among these providers.”

5. Dr. Stratmann conducted a study finding North Carolina’s CON laws are the fourth-most restrictive in the Untied States.

FDA issues update on recalled Custom Ultrasonics endoscope reprocessors

August 22, 2016

Following Custom Ultrasonics’ Urgent Medical Device Recall it sent to customers May 6, the Food and Drug Administration (FDA) is advising users to stop using the manufacturer’s System 83 Plus AERs for reprocessing of duodenoscopes. The notice revises the FDA’s earlier communication regarding the product in February. The FDA now says that the product can remain in service for the reprocessing of endoscopes other than duodenoscopes.

CLICK HERE to see the FDA notice

Letter From GE concerning legality of Software resales

August 19, 2016

Recently, GE sent a letter to equipment brokers and and unknown list of others.  It is included below.  It states that the original buyer of the equipment is not allowed to sell any software that came with the original purchase of the CT, MRI, or other advanced imaging product except for the basic operating software.

This is causing quite a lot of discussion in the biomed and healthcare fields.  What is considered the “base system standard operating system”?  Does any liability fall on the sell, or the buyer?  What will happen if a GE employee discovers software on a machine that should not be there?  What will their procedure be?  Does this apply to ‘hidden’ software that must be turned on with a service key?

We are trying to find out some answers and will update this blog when we have them.


Pat Lynch

GE Healthcare Software Terms of Non-Resale

American College of Surgeons issues new dress code

August 18, 2016

The American College of Surgeons issued new guidelines Monday on appropriate surgeon attire in and out of the operating room.

“It’s important to provide an optimal surgical care environment for our patients. These recommendations for a comprehensive dress policy for surgeons will help us to achieve that goal,” ACS Executive Director David Hoyt, MD, said in a statement.

The guidelines are based on “professionalism, common sense, decorum and the available evidence,” according to ACS. Dress code recommendations include:

See the full list of recommendations here.

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Will accent and obesity sink a job search?

August 18, 2016

An employer can’t legally discriminate over weight or accent, but could it play a role in hiring decisions? (Associated Press)

Karla L. Miller

Question: My stepdaughter, a recent college graduate, is living with her dad and me while looking for a lab research position for which she’d be qualified with an average GPA and a degree from a state school. She has had several phone interviews and one in person, but nothing more.

Stepdaughter has a guttural Southern accent and poor diction. While I get that these are a result of the area in which her now-deceased mother raised her, in my opinion, they make her sound uneducated and lazy. For instance, she pronounces “pen” as “pin”; “can’t” as “cain’t”; and then there’s — horrors — “ain’t”; and that eloquent phrase, “I don’t got no.” It’s my assumption that this may be keeping her from moving further along in the interview process. My husband, her dad, doesn’t want to address it for fear of harming her self-esteem. Any articles or suggestions I have given her are met with disdain.

One last note: She is obese, and I am concerned that this also will work against her. Her dad, again, doesn’t want to risk hurting her feelings, and she is very verbal in telling people that she likes the way she looks (and good for her, I guess).

I realize an employer cannot legally discriminate over weight or accent, but I would value your expert opinion as to whether I have a valid point.

Answer: As a state-school graduate who retains a hint of a drawl, I confess I had to swallow my first five or six reactions to your letter. But you do raise valid concerns for job seekers.

Although even the educated and industrious among us can make mistakes, consistent bad grammar suggests a lack of attention to detail that doesn’t bode well for someone seeking a research position. And there’s no federal law against narrow-mindedly rejecting an applicant for weight or accent, unless those traits can be clearly connected to a prejudice against gender, race or other protected class.

So, yes, those are fair points. But if you’re hoping to use them to helpfully needle your husband’s daughter onto a career path and out of your house, I doubt she’ll take them as anything but concern trolling, however many expert opinions you gift-wrap them in.

Her dad might have a shot at encouraging her to seek “good for now” jobs or look into a job-hunting seminar. Meanwhile, I suggest you try looking at her another way: as a self-confident graduate, motherless too young, who is starting her adult life as a dependent in a home where she likely feels judged and unwanted. Even if she lacks polish, and even if her aspirations exceed her abilities, her confidence and work ethic, bolstered by someone who believes in her, can still carry her far.

Karla Miller writes a column answering questions about work dramas and traumas for the Washington Post.

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