First self-referral CT, now self referral MR

[John Jacobus <crispy_bird@YAHOO.COM>]

>From another list server:

http://www.dimag.com/dinews/2004050501.shtml

--------------

Diagnostic Imaging Online

May 5, 2004 



News from AOCR: MR screening triggers lively debate 

Walk-in CT clinics may be closing their doors, but the

concept of consumer-led preventive imaging is far from

dead. Interest is switching to MR imaging as a

screening tool to reassure the worried well and

highlight dormant disease.



Speakers at this week.s 10th Asian Oceanian Congress

of Radiology meeting in Singapore outlined two schemes

in Europe and Asia that are selling whole-body MR

scans to asymptomatic clients. Presenters then tackled

a series of probing questions regarding the

practicalities and ethics of their projects.



The Imaging Center at Taipei Veterans General Hospital

(VGH) in Taiwan has been offering MR screening on a

pay-per-scan basis since October 2000. A total of 5823

clients had attended the center by June 2003, 4298 of

whom underwent a whole-body MR exam.



A top-to-toe MR scan takes one hour, said Dr. Charles

H. Cheng, Ph.D., an attending physician in the VGH

radiology department and a strong advocate of the

program. Walk-in clients can choose from five MR-based

screening packages:

· whole-body tumor survey

· neurovascular survey

· cardiac survey

· breast screen

· colonography



Ultrasound scans of the breast, thyroid, abdomen, and

carotid arteries are regularly included as part of

relevant packages, and follow-up exams may be included

if radiologists need to clarify suspect findings. 



Clients pay the equivalent of $1000 for a complete

tumor survey and another $1000 for a neurovascular

assessment or for a cardiac screen, Cheng said.

Taiwanese national health insurance then takes over if

clients need medical attention elsewhere.



Self-referrals account for most whole-body MR exams,

which are available to anyone who can pay, he said.

Only clients with two or more risk factors are advised

to undergo neurovascular and cardiac screening.



Cheng accepts that the screening program will attract

criticism but remains adamant that offering Taiwanese

consumers the option of a whole-body scan will do more

good than harm. 



.You have a choice. Either you can do nothing and wait

for the symptoms to appear and then treat the advanced

disease, or you provide the best service you can,. he

said. .Many people from countries that have

comprehensive primary healthcare systems misunderstand

what we are doing. They do not realize that what works

in Asia is sometimes different from what works

elsewhere..



Dr. Matthias Goyen, a radiologist at the MR Center,

University Hospital Essen, in Germany, adopts a more

conciliatory approach toward critics of MR screening.



.I accept that screening is a controversial topic, and

I am not saying we have all the answers right now,. he

said.



Radiologists at Essen have devised a five-stage,

60-minute protocol for whole-body MRI that can pick up

signs of vascular, pulmonary, and colonic disease.

Most fee-paying clients come from local firms that

have paid for staff screening. Trials planned in

collaboration with a health insurance company will

assess the cost-effectiveness of a wider MR screening

program.



.We always have to ask ourselves the question: .What

good are we doing by finding these suspect signs on

MRI?. because we don.t want to cause any more problems

for our customers or patients,. Goyen said.





=====

+++++++++++++++++++

"We cannot escape danger, or the fear of danger, by crawling into bed and pulling the covers over our heads."

-- Franklin Delano Roosevelt



-- John

John Jacobus, MS

Certified Health Physicist

e-mail:  crispy_bird@yahoo.com





	

		

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