News - Radiology Associates ImagingRadiology Associates Imaging

Dimension, Detection, Detail. St. Augustine Imaging Launches 3D Mammography for Early Detection of Breast Cancer – Which Means a Better Chance of a Cure for Area Women

St. Augustine, FL – St. Augustine Imaging, one of six imaging centers operated by RAI in East Central and Northeastern Florida, is the first provider in St. Johns County to offer 3D mammography. The radiology practice selected a Hologic Selenia Dimensions Genius 3D MAMMOGRAPHY™ system.

“Hologic was the first manufacturer to obtain FDA approval for 3D digital breast tomosynthesis, so we view them as the technology leader whose equipment was the best choice for area women,” said radiologist and St. Augustine Imaging Medical Director John E. Agles, M.D. “As the first provider to bring the benefits of 3D mammography to St. Johns County, we’re pleased to be partnering with Hologic.”

What are the benefits of 3D mammograms, and who should consider having a 3D mammogram at St. Augustine Imaging instead of a conventional two-dimensional (2D) mammogram?

“It’s easier to understand when you think of 3D as standing not only for ‘three dimensional’ but for three words that start with the letter D: dimension, detection, and detail,” Dr. Agles said.

“Conventional mammograms usually take four two-dimensional images of the breasts at different angles,” he said. “But a 3D mammogram takes 24 images of the breast tissue at different depths. A computer puts those pictures together, creating a three-dimensional image that lets us see inside the breast much more clearly. That makes us more confident when a mammogram appears normal and when we see abnormalities, which means fewer false positives, fewer callbacks for additional imaging, and fewer unnecessary biopsies. 3D mammograms also make the smallest abnormalities easier to find. That’s vitally important because, when a small abnormality proves to be early-stage cancer, it can be cured—the treatment success rate is virtually 100 percent. So 3D mammograms are beneficial to all women, but especially to those with dense breast tissue, which makes abnormalities harder to find in a conventional mammogram.”

Dr. Agles added that a 3D mammogram takes virtually the same amount of time to complete as a conventional 2D mammogram, and feels essentially the same to the patient.

Currently, 3D mammograms are fully covered for Medicare patients who are within Medicare guidelines for screening mammograms. However, not all private insurers have followed suit.

“I do expect that most insurers will eventually get on board with Medicare in covering 3D mammograms,” Dr. Agles said. “But for now, patients can expect variations depending on their insurance plan. In the meantime, we’re offering patients who are covered only for 2D mammograms the option of a 3D mammogram for a nominal copay. We hope that will help more women benefit from this latest advancement in early detection of breast cancer until private insurers update their coverage policies.”

Did You Know? Our Imaging Centers are Recognized as “Designated Lung Cancer Screening Centers”

By - Lung Cancer Screening

The American College of Radiology (ACR) recognizes each of our 6 imaging centers as ACR Designated Lung Cancer Screening Centers. It signifies that the Radiology Associates Imaging (RAI) lung screening program and protocol meet requirements set forth by the ACR Committee on Lung Cancer Screening.
“We are able to detect lung cancer at its very early stages, which significantly improves the survival of
our patients,” said RAI President Roy Siragusa, MD.

The ACR Lung Cancer Screening Center designation is a voluntary program that recognizes facilities committed to practicing safe, effective diagnostic care for individuals at the highest risk for lung cancer. In order to receive this elite distinction, facilities must be accredited by the ACR in computed tomography (CT) in the chest module, as well as undergo a rigorous assessment of its lung cancer screening protocol and infrastructure. Also required are procedures in place for follow-up patient care, such as counseling/smoking cessation programs.

Lung cancer screening with low-dose CT scans and appropriate follow-up care significantly reduce lung cancer deaths, which total more each year than those related to breast, colon and prostate cancers combined. In December 2013, the United States Preventive Services Task Force recommended screening of adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit smoking within the past 15 years.

DID YOU KNOW? A Patient Educational Article from Radiology Associates Imaging

By - Women's Imaging Services

Figure 1

Did you know that the latest statistics from the American Cancer Society demonstrate a dramatic reduction in breast cancer deaths over the past 20 years?

The data shows that the death rate has declined by 34% between 1990 and 2011 (figure 1). This means that more than 200,000 deaths have been averted! This decrease is likely the result of greater awareness, better treatment, and improvements in mammography screening. We should all be very proud of this accomplishment and continue to improve awareness and promote breast cancer screening.

The research also shows us where there is room for improvement. Over the past 2 years, the percentage of women who should be having screening mammograms (women 40 years of age and older) has leveled off at approximately 67%. That means that about 1 in 3 women are not getting screening for cancer. The American Cancer Society data shows that these women who are not getting screened are more likely to be uninsured and less educated (figure 2). So spread the word and share this information with your friends and family. Hopefully, we will improve screening rates with better awareness.

Figure 2

Please note that this information and graphics are provided by the American Cancer Society and is copyrighted material. This information is from “Breast Cancer Facts & Figures 2013-2014.” For more information, please visit their
website at www.cancer.org.

Educational Videos

By - General Imaging Services

Please click here to view several videos from Dr. Klioze’s You Tube Channel.

New and Improved

By - General Imaging Services

We are continuing our efforts to offer the highest-quality imaging in the communities we serve. Three new CT scanners were recently installed at St. Augustine Imaging, Twin Lakes Imaging, and Port Orange Imaging to ensure that our patients have access to state-of-the-art imaging. This updated technology from GE Healthcare (Optima CT660) offers several advantages over our prior scanners including:

New CT image reconstruction techniques that allow us to reduce the radiation dose required to make diagnostic quality images. In many cases, doses can be reduced by 30% or more.
Increased number of detectors and faster rotation times that will allow shorter breath-hold imaging and ultimately reduced artifacts. The average chest CT exam now only requires a 4 second breath-hold.
Increased weight capacity (up to 227kg or 500 lb.) allowing bariatric patients access to imaging that previously was unavailable.
Green features that result in up to 60% lower carbon emissions.

We are proud to continue our investment in the company and our community. Offering the latest technology to our patients in a compassionate manner is what we are all about.

For any questions about this new technology, feel free to contact Dr. Gianini at jgianini@radassociates.us .

National Cancer Survivors Day

By - Community

The 2014 Flagler County National Cancer Survivors Day event was held on June 1^st in Palm Coast at the Hilton Garden Inn. Radiology Associates and The Walk On Cancer support group partnered again this year to host the event.

National Cancer Survivors Day is an annual, treasured celebration of life that is held in hundreds of communities nationwide and around the world. It is a celebration for those families who have survived, an inspiration for those recently diagnosed, a gathering of support for families, and an outreach to the community. Participants unite in a symbolic event to show the world that life after a cancer diagnosis can be meaningful, productive, and even inspiring.

Radiology Associates was not only a corporate sponsor for the event but two of our Radiologists were also guest speakers. Dr. Scott Klioze served as the Master of Ceremonies and Dr. John Gianini was the Spotlight Survivor Speaker with a discussion on colon cancer.

For more information on National Cancer Survivor Day, please visit their official website at: www.ncsd.org .

Did you Know? A Patient Educational Article Regarding Lung Cancer Cancer Screening

By - Lung Cancer Screening

A patient educational article from Radiology Associates

Did you know that Radiology Associates offers a chest imaging exam that can lower the risk of dying from lung cancer?

This asymptomatic 57 year old smoker had a low-dose lung cancer screening CT at one of our imaging centers. A highly suspicious spiculated mass was detected in the right upper lobe (left image). The lesion was then further evaluated with PET-CT (right image) to further characterize and was show to have abnormal metabolic activity consistent with a cancer. Subsequent biopsy proved this to be a squamous cell carcinoma, a lung cancer almost always caused by smoking.

Lung cancer is the second most common cancer in both men and women with about 224,210 new cases anticipated to be diagnosed in 2014 (source: cancer.org). Although it is second in incidence, it is by far the leading cause of cancer death among both men and women. In fact, more people die each year from lung cancer than from colon, breast, and prostate cancers combined! Despite medical advancements in surgery, radiotherapy, and chemotherapy the long-term survival of patients has remained low.

Since imaging has been shown over the years to sometimes detect small incidental lung cancers, the National Cancer Institute (NCI) funded the National Lung Cancer Screening Trial (NLST) in 2002 to determine if imaging could reduce mortality from lung cancer in high-risk individuals. In 2011, the results from the NLST were published in the New England Journal of Medicine. In this clinical trial, more than 50,000 asymptomatic current and former smokers were studied. The results demonstrated a 20% decrease in lung cancer mortality (death) in the patients screened with low-dose chest CT. These results were later reviewed by the United States Preventative Services Task Force (USPSTF) and given a grade that supports annual screening with low-dose chest CT for high-risk individuals.

“The chest radiology community is very excited about this new data on decreasing lung cancer mortality in smokers,” explains Dr. Joseph Cox. Dr. Cox is one of our Radiologists who is fellowship trained in Thoracic Imaging, which is a field specializing in imaging of the lungs and heart. He adds, “Our hope is that as more data becomes available, low-dose chest CT for lung cancer screening will be covered by insurance companies, just like mammography.”

Based on the promising results from the NLST, Radiology Associates Imaging has partnered with Halifax Health to offer a low-dose screening chest CT that meets all national guidelines. If a patient meets the appropriate screening criteria, they can receive a low-dose chest CT scan for $99.

Summary Recommendations from the USPSTF:

Annual screening for lung cancer with low-dose CT in the following setting:

Adult aged 55 to 80 years
A 30 pack-year or greater smoking history
Currently smoke or have quit within the past 15 years

Note: Screening should be discontinued once the individual has not smoked for 15 years or develops a health problem that significantly limits life expectancy or the ability or willingness to have lung surgery.

What is a pack-year?

This is calculated by multiplying the number of packs per day by the number of years smoking. For example, if someone has smoked 1 and a half packs of cigarettes per day for 30 years, they have a 45 pack-year history. (1.5 x 30 = 45 pack-years)

We will soon have more information on low-dose lung cancer screening CT on our website. If you have any questions, you can reach Dr. Cox via email at jcox@radassociates.us or Dr. Gianini at jgianini@radassociates.us.

Here is a good resource for additional information on Lung Cancer and low-dose screening CT: www.lungcancerscreeningsaveslives.org .

Introducing the Biggest News in MRI

By - General Imaging Services

Don’t get too comfortable. Scan times are as short as ten minutes! Radiology Associates Imaging is excited to offer the world’s best MRI to East Central Florida. With our new Verio 3.0 Tesla ultra-High Field Open Bore MRI’s, we are able to combine the highest level of comfort with the highest level of diagnostic confidence available today.

With the strongest magnetic field strength used clinically, the 3.0 Tesla MRI is ideal for numerous applications including neurology, orthopedics, breast and vascular imaging.

Announcing the area’s first facilities to earn the prestigious ACR Breast Imaging Center’s of Excellence Designation.

By - Women's Imaging Services

The ACR (American College of Radiology) awards accreditation to facilities of high practice standards after a peer-review evaluation of the practice. Evaluations are conducted by board-certified physicians and medical physicists who are experts in the field. They assess the qualifications of the personnel and the adequacy of facility equipment. The surveyors report their findings to the ACR’s Committee on Accreditation which subsequently provides the practice with a comprehensive report.

The Breast Imaging Center of Excellence is given only to centers whose quality earns ACR accreditation in Mammography, Stereotactic Breast Biopsy and Breast Ultrasound. Both our Twin Lakes and St. Augustine Imaging facilities were awarded this esteemed accreditation. For more information about the ACR and its guidelines, visit www.acr.org or call us at 386-274-5454.

Did you know? A Patient Educational Article from Radiology Associates Imaging

By - Men's Imaging Services

Did you know that Radiology Associates Imaging offers a prostate imaging exam that can detect prostate cancer that is missed by biopsy?

Take a look at the images below:

This patient had an elevated PSA value and negative ultrasound-guided prostate biopsy. After the MRI showed an abnormality (arrows) suspicious for prostate cancer in the central gland, the Urologist performed a repeat biopsy targeted to the area of interest. Pathology demonstrated prostate adenocarcioma.

“The patient’s urologist was concerned with the rising PSA value and he understood that even though the biopsy results were negative, that doesn’t guarantee that there isn’t a cancer present,” states Dr. John Gianini. Dr. Gianini is one of our Radiologists who is fellowship trained in Abdominal Imaging, which is a field dedicated to imaging the gastrointestinal and genitourinary systems. He adds, “With a standard 12 sample prostate biopsy only a small portion of the prostate gland is evaluated, especially in men with enlarged prostates. This results in the possibility of missed cancers that may be clinically significant.” More Urologists are now considering prostate MRI as a complementary exam to the PSA blood test and prostate gland biopsy in patients with persistently rising PSA values.

Prostate MRI is performed on one of our high-field strength 3 Tesla MRI units using state-of-art technology. “Since we are using a 3 Tesla scanner, we are able to perform the exam without the use of an endorectal coil,” Dr. Gianini explains, “Also it allows us to perform high quality functional imaging including perfusion, diffusion, and spectroscopy. The patients are getting the highest quality exam available.”

As this case highlights, prostate MRI has become more relevant in the diagnosis and management of prostate cancer. Its precise role in the work-up of prostate cancer is still being defined through research but may be helpful in the following setting:

Elevated PSA with negative biopsy
Staging for biopsy proven prostate cancer
Radiation therapy treatment planning
Detection of local recurrence after treatment

We will soon have more information on prostate MRI on our website. If you have any questions, you can reach Dr. Gianini via email at jgianini@radassociates.us .

For more information on Prostate MRI, please visit RadiologyInfo.org.