MDNews - Minnesota

COVER FEATURE avoid damage to adjacent areas of the brain during surgery, physiologic information — such as cerebral blood flow and perfusion, diffusion tensor imaging with white matter fiber tracking, and functional motor and language mapping — is used to provide a more accurate target for areas of biopsy or resection. It Doesn't Matter Where You Sit CRL provides on-site radiologists, the radioactive tracing agent technetium 99, intravenously into the arm or foot. A nuclear medicine — or gamma — camera scans the breasts, looking for cancerous cells, in which the radioactive tracer gath- ers in higher concentrations and appears as bright spots on the images. Although these tests do not replace mammography, they have proven extremely useful in detecting small abnormalities (less than 1 centimeter) that did not appear on original mammographic images. In the last 16 months, CRL has performed an estimated 140 BSGI exams. In the last year, CRL performed approximately 70 MBI exams. According to the "2012 Quality Report," indications for the patient groups ben- efiting most from BSGI/MBI tests are: "patients with vague clinical or mam- mographic concerns and negative findings on diagnostic workup" and patients who are unable to be imaged using magnetic resonance imaging (MRI) technology, but who meet the criteria for it. In the former group, the report's authors state that patients will be returned to annual screening mammography upon a negative BSGI/MBI study, which immediately stops the workup and eases the minds of the patient and referring physicians. Demonstrated Expertise in Neurointerventional Radiology Using some of the most advanced techniques, such as intra-arterial stroke treatment, to treat difficult cases, CRL's neurointerventional radiology team has distinguished itself within the local 10 | Twin Cities MD NEWS ■ MDNEWS.COM medical community. These subspecialty radiologists have endovascularly treated more than 1,600 aneurysms, one of the largest volumes of such treatment in the nation. CRL's neurointerventional radiologists are located in the Neuroscience Institute at Abbott Northwestern Hospital, a leading center for neurological care in the region. This provides the opportunity for CRL's specialists to team with intensivists, inter- ventionalists, neurologists, neurosurgeons, neuro-oncologists and otolaryngologists to provide patients truly comprehensive care for any neurological needs that arise. Innovative Technology and Collaboration in Neurodiagnostics A dynamic collaboration in neurodiag- nostics is demonstrated by the offering of intraoperative neurosurgical imaging. A CRL diagnostic neuroradiologist attends every intraoperative MRI procedure utilized by Abbott Northwestern Hospital. This procedure provides visualization to surgeons resecting parts of the brain, thereby allowing for a more complete tumor removal and reducing the risk of damage to adjacent tissues. Authors of the "2012 Quality Report" indicate that, since its installation at Abbott Northwestern Hospital, pre- and intraoperative functional MRI has been used more than 500 times. Using new software from Brainlab, neurologists combine anatomic and functional data in a three-dimensional preoperative plan. As another precautionary measure designed to teleradiology and outpatient services to more than 100 facilities in a five-state region. Partnering with CRL instantly gives providers access to one of CRL's proprietary innovations — Consulting Radiologists Teleradiology Information System (CRTIS). Utilizing an extensive teleradiology network, partnering institu- tions can send images through the system to subspecialists at CRL for interpretation. All pertinent information from a patient's record is located conveniently in one place and is available in real time. This system is secured in full compliance with the Health Insurance Portability and Accountability Act (HIPAA). CRL is able to provide subspecialty cover- age and interpretation around the clock, every day of the week, to the Twin Cities area and the Midwest. Its teleradiology capabilities are currently utilized in five states and are easily expandable as CRL grows its network of partners. For small or rural hospitals, CRTIS makes available the services of highly skilled subspecialty radiologists, no matter where the hospital is located. "The standard of practice is evolving toward the medical community expecting subspecialty interpretations on exams specific to the imaged area," says Dr. Sidney. "The standard of practice is such that most people would expect an MRI of the brain to be read by a physician who is a subspecialist in neuroradiology." Another major quality advantage of CRTIS, Dr. Sidney notes, is peer review. The touch of a button allows second readers to dictate or type their interpretations, which are just a mouse-click away from the initial readers. This system was designed as a tool for peer review and to provide access to referring physicians. ■

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