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MRI Scans, Pacemakers, and Implantable Cardioverter-Defibrillators: New Safety Evidence

2 Feb 2018 MRI , ,

Patients with pacemakers and implantable cardioverter-defibrillators (ICDs) may safely receive magnetic resonance imaging (MRI) testing according to a study from the New England Journal of Medicine. Currently, implanted devices must meet the Food and Drug Administration’s criteria to be considered MRI-conditional. The pacemakers and ICDs that do not meet these requirements are considered legacy devices, and the federal government considers them unsafe for MRI scans. However, the new study proves that, with adherence to protocols, patients with legacy devices can safely receive MRI scans.

 

The study followed over 1500 patients with implanted devices.

 

The prospective, nonrandomized study followed 875 patients with pacemakers and 634 with ICDs. All patients had implanted devices that were considered legacy devices —  that is, they did not meet the requirements of the Centers for Medicare & Medicaid Services (CMS). Researchers from the University of Pennsylvania performed MRIs on the patients only when it was deemed clinically necessary.

 

The scans were done under strict protocols with physicians on hand to monitor patients. Tachyarrhythmia functions were disabled on the machines and pacing modes were appropriately adjusted on the devices.

 

“We found MRI examinations to be safe in the setting of legacy cardiac pacemakers or ICD systems, when using a safety protocol,” lead study author and University of Pennsylvania professor Saman Nazarian told Cardiovascular Business. “The scans were safely performed even when performing thoracic or cardiac MRI and with patients that were dependent on cardiac pacing for every heartbeat.”

 

A previous study from MagnaSafe found similar results for non-thoracic scans.

 

The MagnaSafe Registry is a multi-center study attempting to determine how safe MRIs are for patients with pacemakers and ICDs. They published findings several years ago that upended the traditional view that MRIs were too dangerous for patients with legacy devices. With similar results to Nazarian’s study, MagnaSafe found that there were almost no clinically relevant problems caused by the scan.

 

This is hugely important because many people with legacy implants are denied MRI scans by Medicare and Medicaid. While doctors may then order computed tomography (CT) scans, MRIs are better at diagnosing certain diseases, particularly in the brain and spinal cord. Nazarian said that if a patient with a legacy device needs an MRI, they should contact a medical center that can safely conduct the scan.

 

“Many centers across the U.S. are capable of performing safe imaging despite your device,” Nazarian said to Cardiovascular Business. “MRI can be instrumental in providing the right data for appropriate treatment planning in the setting of many neurologic, cardiac and musculoskeletal disorders as well as malignancies.”

 

The results from the two studies offer compelling evidence that MR technology is safe for those with implanted legacy devices.

 

According to Robert Russo, a doctor in the MagnaSafe study, more than half of patients with implanted devices will eventually need an MRI. Replacement with an MRI-conditional device is not an option, as the complication risks are too high. Therefore, it’s important to determine the safety of MRI scanning for patients with these legacy devices.

 

The above studies show how MRIs pose minimal risks while bestowing life-saving advantages for those who need scans. The FDA and CMS have not changed their regulations in light of the findings, but the evidence is mounting that they should consider doing so.

 

References:

 

Getting an MRI if you have a pacemaker. Harvard Health Publishing. August 2015;Web. Available from: https://www.health.harvard.edu/heart-health/getting-an-mri-if-you-have-a-pacemaker

 

Nazarian S et. al. Safety of Magnetic Resonance Imaging in Patients with Cardiac Devices. The New England Journal of Medicine. December 2017;377:2555-2564. doi:10.1056/NEJMoa1604267

 

Slachta A. MRIs proven safe for patients with with FDA-unapproved implantable devices. Cardiovascular Business. January 2018;Web. Available from: http://www.cardiovascularbusiness.com/topics/electrophysiology-arrhythmia/mris-proven-safe-patients-fda-unapproved-implantable-devices

 

The MRI Procedure in 10 Steps: Managing Patient Anxiety Through Information

10 Jan 2018 Health Care, Medical, MRI

 

A first-time MRI procedure can make patients nervous, even to the point of ending the scan. That can lead to higher costs for imaging centers, and even affect patient outcomes if the anxiety interferes with the quality of the radiology report. Research shows one simple way to help nervous patients get through their scans without interruption: Communication.

 

A 2015 study in the journal Magnetic Resonance Imaging tested an intervention in which imaging staff explained the MRI process to one group of patients. They took blood samples during the scans, later testing them for the stress hormones prolactin and cortisol. Additionally, they took both the experimental and control groups through the 40-questions State-Trait Anxiety Inventory to measure patient nervousness.

 

The patients who had the intervention in which staff verbally shared information about the scan showed a 6-percent drop in cortisol after the scan. The control group’s cortisol levels increased by 18 percent. The authors of the study conclude that “MRI anxiety can be reduced by information and communication. This combined method is shown to be effective and should be used during daily radiology routine.”

 

So what can physicians do to prepare their patients for a first MRI scan in advance? It’s never too early to start educating patients about what they can expect during a health procedure. And the MRI process can be boiled down into 10, easy-to-grasp steps. Share these steps with patients to help limit anxiety during an MRI scan:

 

  1. First, radiology staff will walk the patient through a detailed screening process. Because of the strong magnetic field generated during an MRI, patients must report any medical implants or metal particles in their bodies. These may preclude the use of MRI imaging. 
  2. Once the patient clears the screening, staff will lead them into the MRI suite. Some imaging facilities offer hospital robes, to ensure there’s no metal in the patient’s clothing. Others allow patients to wear their own metal-free clothes, such as sweat pants and a T-shirt. The technologist will proceed to position the patient on the table; most commonly, patients lie on their backs. If the scan requires an additional radiofrequency coil, the technologist will place that on the patient’s body at this time.

  3. The patient enters the bore. Meanwhile, technologists cycle through a list of pre-programmed settings called “protocols.” They’ll choose the protocol that corresponds with the body part they are imaging; this will tell the MRI machine which angles, targets, and pulse sequences to use in this particular procedure.

  4. Before the scan proper begins, technologists run a “scout” or “localizer” scan. This is a low-quality image, and it won’t be used in reporting. However, localizer scans obtain visual and placement information that the computer will used to plan the angles of its imaging later in the process.

  5. Parallel imaging is a process designed to speed up scan time. It collects less raw data during the scan, and patches missing information using special algorithms to generate the final image. Parallel imaging requires specifically calibrated coils, and may call for a calibration scan at this point.

  6. One of the great strengths of MRI scans is that they create 3D images that can be viewed from any angle. The next step is to program in the angle of images for the radiologist. Technologists can change the “thickness” of the image at this point, as well.

  7. Before the scanner can begin collecting valuable images, it must calibrate all systems through the use of a prescan. This shouldn’t take much more than 10 or 20 seconds.

  8. It is only at this relatively late stage in the process that the technologist actually runs the scan. They will make necessary adjustments and continue scanning according to the chosen protocol. In the end, they’ll have clear, accurate images that radiologists will use in their reporting.

  9. Some types of images require extra work in post-production, but this can be done after the patient has left the MRI suite.

  10. Scanning complete, the technologist pulls the patient from the bore. Different types of scans take varying lengths of time, but most range between 20 and 60 minutes.      

 

When patients understand more about their medical procedures, and know what to expect, they’re less likely to experience significant anxiety. That’s both a value in itself — as patient-centered caregivers, staff at Precise Imaging works to keep patients comfortable, both physically and emotionally — and an element of better diagnoses, which lead to better patient outcomes.

 

To learn more about an MRI procedure from Precise Imaging, or to refer a patient, call us at 800-558-2223.  

 

References:

 

Deshmane A, Gulani V, Griswold MA, Seiberlich N. Parallel MR imaging. Journal of Magnetic Resonance Imaging: JMRI. 2012;36(1):55-72. doi:10.1002/jmri.23639

 

Elster AD. “Performing an MR Scan.” MRIQuestions.com. 2017. Web. Jan. 8 2018.

 

Tazegul G, Etcioglu E, Yildiz F, Tuney D. Can MRI related patient anxiety be prevented? Magnetic Resonance Imaging. 2015;33(1):180-3. doi:10.1016/j.mri.2014.08.024

 

Insurers Demand Independent Imaging Centers: What Physicians Should Tell Patients

4 Jan 2018 Facilities, Health Care, MRI

Independent imaging centers are moving to the forefront of diagnostic care in the United States. Recently, at least one major health insurer dropped coverage for CT and MRI scans at hospital radiology facilities. The insurance company will only pay for these scans when patients visit providers who specialize in diagnostic imaging, and imaging alone.

 

How will this change the conversation between referring physicians and their patients? In order to explain the changes — why insurers would make a rule like this, and why it’s not at all a bad change for patient care — physicians need only look at two key metrics of today’s health care system: price and quality.

 

The Price Difference Between Hospitals and Independent Imaging Centers

 

When an insurance company makes a move like this, it’s a clear indication that there’s a wide price differential that’s not necessarily associated with a difference in quality of care. Research from the Healthcare Financial Management Association — a professional organization for people who work on the financial side of the health care industry — shows that prices at hospitals are, in fact, dramatically higher than those at the average free-standing imaging provider. Among other differences, the HFMA found:

 

  • MRI scans cost an average of 70 percent more at hospitals than at independent imaging centers.
  • When those MRI scans covered the head and/or neck, they were an average of 80 percent more expensive in hospital-owned facilities.
  • The differences were even more stark for CT scans. Imaging of the body using CT cost 135 percent more at hospitals.
  • For CT scans of the head and/or neck, patients paid an average of 149 percent more at hospitals than at free-standing imaging facilities.

 

This research was published in 2017, though most of its data came from 2014. Either way, price gaps remains.

 

Measuring the Quality of Diagnostic Imaging Providers

 

Patients are used to associating higher prices with better service. In health care, however, quality and cost are independent of one another. The United States has the most expensive health care in the world.

 

In 2014, U.S. health care spending per capita was $9,237. That year the United Kingdom spent $3,749 per person while Japan’s figure stood at $3,816. Still, among the 12 wealthiest industrialized nations — including Japan and the UK — the United States lands dead last in terms of life expectancy.

 

Clearly, spending more does not buy better care in this country. In fact, independent imaging centers offer measures of quality, in terms of better patient experience, that most hospitals cannot boast. At Precise Imaging, these include:

 

  • Evening and weekend hours to work around the patient’s schedule, not the other way around.
  • Excellent, board-certified radiologists and technicians, often the same ones hospitals use, at a drastically reduced cost.
  • Quick reporting with HIPAA-compliant online sharing with referring physicians. Most doctors are reading radiology reports within 24 hours of the scan.
  • Same-day scheduling.  
  • Transparent pricing.

 

There have been plenty of good reasons to refer patients to a free-standing imaging facility for years. Now that insurers are refusing to support the arbitrary and inflated costs that hospitals charge, more and more patients will be able to experience the care that Precise Imaging provides.

 

The Expanding Use of MRI in Personal Injury Law

21 Dec 2017 MRI, Personal Injury , ,

 

Personal injury attorneys have relied on MRI scans to bolster their clients’ claims for years, but the role of this crucial technology may soon grow dramatically. As a diagnostic imaging modality, MRI is ideal for recording soft tissue injuries, including disc protrusions and herniations and muscle tears. But even perfect documentation of these injuries doesn’t necessarily prove a devastating type of affliction that’s all too common, and often difficult to demonstrate: chronic pain.

 

Pain is a subjective sensation. One person’s agony might be another’s slight discomfort, and defense attorneys have a history of leaning on this subjectivity to reduce damages. Meanwhile, though, patients’ lives can be destroyed; ravaged by pain, they might not be able to work, or even perform daily tasks of living. A fair settlement might be the only thing that stands between them and utter destitution.

 

But how can an MRI scan document pain? Neuroscientists say they’re right on the verge of an answer.

 

Using MRI Technology to Track Pain’s Pathways in the Brain

 

A specialized type of MRI scan, functional magnetic resonance imaging, or fMRI, measures blood flow within the brain. When a certain region of the brain activates, cerebral blood flow in that area increases. The fMRI tracks these changes.

 

Brain mapping allows neuroscientists to associated certain areas of the human brain with general functional experiences within the thinker — including, perhaps, the thinker’s experience of pain. If an attorney could demonstrate that a client’s brain activity is consistent with chronic pain, that could be enough to sway the judge. However, we’re not quite ready to break out the fMRI scans in tomorrow’s personal injury case.

 

Hurdles in the Use of fMRI Scans for Personal Injury Cases

 

Neuroscientists are still debating the reliability of fMRI to demonstrate chronic pain. Most of the studies involving pain and brain mapping have been conducted on acute pain, not the chronic variety. Some scientists argue that patients could “cheat” the scan, imagining a greater-than-baseline intensity of pain.  

 

The science behind demonstrating pain with fMRI scans isn’t quite up to courtroom standards yet, but it’s close, and it’s getting closer. With every new study on the subject, fMRI technology inches toward a future in which pain is as visible as a broken arm in an X-ray.

 

Meanwhile, standard MRI scans continue to be an important element in many personal injury cases. This technology has changed the way personal injury law functions, and it appears it will continue to do so in a broader range of cases soon.  

 

References:

 

Cherniak, Todd. “Litigation MRI: Why lawyers are asking for it and why your patients need it.” BCMJ. British Columbia Medical Journal, Sept. 2005. Web. 20 Dec. 2017.

 

Davis, Kevin. “Personal injury lawyers turn to neuroscience to back claims of chronic pain.” ABAJournal. American Bar Association, Mar. 2016. Web. 20 Dec. 2017.

 

Geddess, Linda. “Human brain mapped in unprecedented detail.” Nature. Macmillan Publishers Limited, 20 July 2016. Web. 20 Dec. 2017.   

 

radiologists

Radiologists and Referring Physicians: Better Communication, Better Outcomes

1 Dec 2017 MRI , ,

Radiologists and referring physicians need dependable, clear communication to collaborate on  accurate diagnoses for their patients. When that communication is lacking, the risk of errors can quickly compound.  

 

Annette Johnson, MD, MS, describes a particularly worrisome case on the Agency for Healthcare Research and Quality website. This is an example of what can go wrong when physicians and radiologists don’t have quick, easy-to-use access to one another.  

 

Radiology Report Transmission Errors: An Alarming Story

 

A 62-year-old man was admitted to the hospital with swelling in his abdomen and legs, Johnson reports. His right leg was slightly more swollen than the left, and the attending physician was concerned that he might have a deep vein thrombosis (DVT). The physician ordered an ultrasound to check for evidence of a blood clot.

 

The imaging procedure didn’t show any signs of DVT. The radiologist called the primary care team and told them this verbally after dictating the report, so the team continued to treat the man with the understanding that he did not have a DVT. All was well up to this point.  

 

The problem occurred when the night team rotated in. As the radiologist verbally dictated the report, it turns out, the dictation system clicked just as it recorded the words “no DVT is seen” — obscuring the word “no.” As a result, the hospital’s voice recognition software recorded the phrase “DVT is seen.” That’s the statement that made it into the truncated radiology report, which the night resident read when beginning the shift.

 

This confusion eventually led to two unnecessary surgeries: One to place a filter in a blood vessel leading to the lung, to block the (nonexistent) blood clot; and the other to remove the filter after someone finally tracked down the reporting radiologist and learned about the mistake. The good news is that there were no complications, and the patient emerged from the surgeries no worse for wear.

Improving Communication Between Radiologists and Referring Physicians

So where did the care team go wrong in this case? Let’s break the issues down into two categories: technology and procedure.

 

  1. There were two clear technology issues in this case: First, a microphone that clicks when activated, and second, the voice recording software’s inability to understand the word “no” beneath the click.

 

But the case also illustrates the simplest way around reporting errors. Remember that when the patient was first admitted, the reporting radiologist spoke directly to the primary care team. That sort of one-on-one interaction is ideal.

 

At Precise Imaging, we offer a physician’s web portal that allows real-time sharing, analysis, and annotation of diagnostic images. This provides yet another way for physicians and radiologists to collaborate directly, no matter where they are.

 

  1. As for procedural issues, Johnson points out that dictation using VRS is more error-prone than using human transcriptionists. Of course, her report dates back to 2011, and voice recognition systems have improved since her estimation.

 

The team also missed the opportunity to provide all physicians involved in the patient’s care with access to more information — while the truncated radiology report might have read “DVT is seen,” with access to images, annotations, and detailed analysis, the night resident might not have proceeded under the assumption that a blood clot was present. Again, comprehensive image-sharing web portals for physicians offer greater communication between radiologists and physicians.

 

Physician web portals aren’t the only innovation that can improve information-sharing between all members of a medical care team. You also need experienced, board-certified radiologists who work onsite in the U.S. to read diagnostic images, such as those at Precise Imaging.

 

All of our radiologists are devoted to patient care, and that means excellent communication with doctors, every time. Radiologists and referring physicians can work together to improve patient outcomes — but only if they commit to quality communication.

breast-mri

Rethinking Breast MRI Cancer Screening

20 Nov 2017 Health Care, MRI ,

Breast MRI is not a first-line breast cancer screening tool for most women. The American Cancer Society recommends annual MRI screening only for women with a lifetime risk of breast cancer that’s greater than 20-25 percent, and only as an adjunct to mammography. The problem is that MR images are too clear, leading to too many false positives, the ACS explains.  

 

“While the high rate of biopsies and further investigations is acceptable in women with a high risk of breast cancer, the number of such investigations in women at lower risk will be much higher than would be appropriate, leading to the need to counsel women in lower risk categories that MRI screening is not advisable and that the harms are believed to outweigh the benefits,” wrote researchers for the American Cancer Society Breast Cancer Advisory Group in the ACS guidelines in 2007.

 

However, a study published in the May 2017 issue of the journal Radiology suggests that it could be time to rethink these recommendations. Researchers from the University of Aachen studied 2120 women, aged 40 to 70, with lifetime breast cancer risk factors of less than 15 percent. The women received screening via MRI, ultrasound, and mammography between 2005 and 2013.

 

Of the 60 cancers discovered in the study, 59 were observed using MRI scans. None were uncovered by ultrasound or mammography alone. Meanwhile, the positive predictive value of the MRI screening was high, hinting that concerns over false positives may be exaggerated given current MR technology and advances in radiology practice.

 

“In women at average risk for breast cancer, MR imaging screening improves early diagnosis of prognostically relevant breast cancer,” the authors concluded.

 

Other Factors Limiting the Use of Breast MRI Screening

 

Even if further studies show that false positives are no longer as prevalent in MRI breast screening as they once were, other barriers continue to limit patient access to the procedure.

 

There are two major reasons physicians don’t order more breast screening via MRI, reports Radiology Today magazine: Insurance companies won’t cover breast MRI for women unless they show high risk, citing excessive costs for the procedure; and there simply aren’t enough MRI providers across the nation.

 

These are concerns that patients and physicians in many parts of California, Nevada, and Arizona needn’t worry about. Precise Imaging operates a growing network of more than 70 free-standing imaging centers in communities across these states — with more on the way.

 

Precise Imaging Expands Access to Breast MRI Scans

 

By providing access to MRI scans within many communities, Precise Imaging allows patients to schedule appointments when and where they please. This greatly expands the total MRI capacity in areas where Precise Imaging operates.

 

As for the issue of cost, Precise Imaging provides a streamlined, flexible billing system, allowing patients to pay through as many avenues as possible. That includes Medicaid/Medicare, PPO insurance, personal injury liens, letters of protection, and low cash prices.

 

And because Precise Imaging providers aren’t attached to a broader hospital system, they don’t have to balloon prices to cover high-loss areas, such as emergency services. Together, these factors allow Precise Imaging to offer more diagnostic imaging procedures — including breast MRI — to more patients at a lower cost.   

 

Some day soon, breast MRI might becomes a standard screening procedure for all women, with life-saving results.

 

References:

 

Kanal K, Butler P, Sengupta D, Bhargavan-Chatfield M, Coombs L, Morin R. U.S. Diagnostic Reference Levels and Achievable Doses for 10 Adult CT Examinations. Radiology. 2017 284:1, 120-133. doi:10.1148/radiol.2017161911

 

Saslow D, Boetes C, Burke W, et al. for the American Cancer Society Breast Cancer Advisory Group. American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography. CA: A Cancer Journal for Clinicians. 2007 57: 75–89. doi:10.3322/canjclin.57.2.75

 

Yeager, D. MRI Monitor: Brevity is the Soul of It. Radiology Today. 2017 18:10, 28. http://www.radiologytoday.net/archive/rt1017p28.shtml

 

Precise Imaging to Open New Anaheim Location

10 Nov 2017 Health Care, MRI, Personal Injury ,

Precise Imaging to Open New Anaheim Location, Expanding Availability of Patient-Centered Diagnostic Care with Unparalleled Access for Physicians

 

November 10, 2017 — Anaheim, California —  Precise Imaging, a private corporation owned by Jaklin Benji, Matt Benji and Mike Rashidi, will open a new facility at 3174 West Lincoln Ave., in Southwest Anaheim, on the 13th day of November 2017. As a leading independent provider of diagnostic imaging services across California, Nevada, and Arizona this latest location will feature a state-of-the-art open MRI scanner.  The opening of an Anaheim location will create even more flexibility for those in need of imaging services while expanding access for referring physicians and their patients.

 

“Access to quality care is our highest priority,” said Danny Rackow, director of technology and operations at Precise Imaging. “The new Anaheim location gives doctors and patients yet another quality source for MRI procedures while bringing the  benefits of an open MRI to a whole new community.”

 

The Anaheim location adds to Precise Imaging’s growing network of over 100 locations, many of which offer evening and weekend hours, same-day referrals, and 24-hour turnaround on radiology reports—even less for STAT cases.

 

Patient-Centered Care with Physician-Preferred Workflow

 

In keeping with Precise Imaging’s mission to build dependable relationships with referring physicians in every medical specialty, the new location will offer a powerful suite of digital resources for health care providers. Physicians can make referrals at any time through a free online form. Following the procedure, they can view radiology reports and images 24 hours a day through a simple, HIPAA-compliant web portal. Experienced IT staff is available at every hour of the day and night to assist physicians with all digital tools.

 

“Doctors should be able to focus on care and not get bogged down on the simplest interactions such as scheduling, availability and ease of use with a provider,” Mike Rashidi said. “We built our physician access tools to make the entire process hassle-free, from referral to reporting to interacting with insurance providers, because we want what the doctors want: better health outcomes for patients.”

 

Precise Imaging has a proven track record of patient satisfaction, and the new location will continue this tradition. The inclusion of a comfortable open MRI scanner in the latest facility is just one example of the compassionate care that sets Precise Imaging apart. Friendly, experienced staff and board-certified radiologists take the time to provide support for the whole patient—body and mind—and that can lead to better, more actionable reports.

 

Continued Partnerships with Personal Injury and Workers’ Compensation Attorneys

 

*Legal professionals who serve clients in Anaheim will benefit from the establishment of the new Precise Imaging location. The company has a long history working with injured clients, and has developed a streamlined and efficient work flow that can provide case-winning medical evidence right on schedule.

 

*Physicians can refer a client online with the click of a button and reach out for support any time through a dedicated web portal. All Precise Imaging locations accept personal injury liens, letters of protection, and workers’ compensation liens.

 

“We’ve helped thousands of attorneys seek justice for their clients, and that mission continues with our new facility,” says Matt Benji.

 

To learn more about Precise Imaging’s new location, or to schedule an appointment anywhere in the network, call 800-558-2223.

 

About Precise Imaging

 

Precise Imaging is a leading provider of MRI, X-ray, PET, and other diagnostic services with locations across California, Arizona, and Nevada. The company offers industry-leading support for physicians and attorneys with best-in-class patient care. Flexible billing options include Medicaid/Medicare, PPO insurance, personal injury liens, cash prices, and more. To learn more about Precise Imaging, please visit www.precisemri.com.    

Should Physicians Order MRI Scans for Personal Injury Litigation?

8 Nov 2017 Medical, MRI, Personal Injury , , ,

Should Physicians Order MRI Scans for Personal Injury Litigation?

 

Physicians are rightfully reluctant to order MRI scans on patients they can confidently diagnose using other means. The clarity of the MRI image is, paradoxically, the reason why many physicians use them sparingly; MRI scans reveal asymptomatic abnormalities that can lead to false positives if doctors are overzealous in their diagnosis.

 

However, there are compelling reasons why physicians should still bow to attorney requests for MRI scans in personal injury cases. In fact, according to a 2005 argument published in the British Columbia Medical Journal, MRI scans were remarkably common in U.S. personal injury cases. This is no time for that to change. Here’s why:

 

  1. False positives can be controlled by the reporting radiologist’s scrutiny and the health care team’s other diagnostic efforts.  

 

MRI scans alone might result in inaccuracies, but physicians don’t see these results in a vacuum. Medically, the MRI scan is one part of a larger diagnostic whole. Meanwhile, legally, the scan images can convince the court of the claim’s validity.   

 

  1. MRI scans can provide clear, convincing evidence of injury in many cases.

 

There’s no clearer way to show soft tissue damage than an MRI image, which can be colored to highlight areas of interest, and even displayed in three dimensions.

 

 

  • The use of MRI protects physicians from later claims of negligent care in the unfortunate case that a more serious injury is revealed in the future.

 

 

If an MRI scan could have revealed an injury, and the physician fails to order one, that could leave the doctor vulnerable to legal action.

 

  1. It’s easy to schedule quick, accurate, and affordable MRI scans.

 

Legal cases happen on a strict schedule, which is why Precise Imaging ensures a quick turnaround on reports, same-day scheduling, and fair pricing.   

 

  1. The costs of MRI are often recoverable in personal injury cases.

 

All Precise Imaging locations accept payments via personal injury lien and letters of protection, so if the patient wins the case, the procedure is covered.   

 

The Value of MRI Images in Personal Injury Cases

 

MRI technology is a crucial tool for diagnosing problems with the brain, spinal discs, nerves, joints, and muscles that may not be detected using other methods. These soft tissues are often associated with personal injury cases stemming from car accidents or slips and falls. Once the medical team makes the diagnosis, recovery can begin — and the case can play out.  

 

From a legal perspective, the images produced by an MRI scan can help win cases and might even increase the value of the claim, which ultimately benefits patients, doctors, and attorneys. MRI results are objective and can be used as a helpful “final word” in a legal setting. By using MRI scans in mediation or at trial, lawyers can fight for what patients need to cover their health care, now and in the future. That’s a worthwhile goal for physicians as well.  

 

To learn more, or to make a referral, call Precise Imaging at 800-558-2223.

5 Ways Radiology Technologists Reduce Patient Claustrophobia During MRI Scans

2 Nov 2017 Health Care, Medical, MRI , , ,

5 Ways Radiology Technologists Reduce Patient Claustrophobia During MRI Scans

 

Physicians strive to prevent distress in patients at every turn, but between 4 and 30 percent of patients who undergo MRI scans still report some level of anxiety. This isn’t just a problem for patients; claustrophobic reactions can add considerable time to MRI scans, and can even adversely affect clinical findings through lower-quality images.

 

Even worse, according to a 2007 article published in the Journal of Magnetic Resonance Imaging, claustrophobic patients abort around 2 million MRI scans around the world every year. That deprives physicians of much-needed diagnostic images.  

 

The good news is that radiologists and technologists have developed interventions that can help to reduce claustrophobic reactions leading up to and during the procedure. As the first point of contact with patients, referring physicians can help lay the groundwork for a comfortable, anxiety-free patient experience by explaining how technologists can help alleviate their fears as soon as a patient expresses trepidation about the upcoming imaging exam.

 

To that effect, here are some of the latest techniques and strategies physicians can explain to nervous patients when they refer them for an MRI scan:

 

  1. The first step to treating anxiety is to recognize that it is occurring, and technologists are trained to look for signs of discomfort throughout the entire patient interaction.

 

A 2013 study published in the International Journal of Behavioral Medicine used both subjective self-reports before and after the procedure to gauge patient anxiety. The researchers also measured electro-physiological reactions during the entirety of the study scan. Their findings suggest that patients tend to be most anxious at the beginning of the scan, as they enter the MRI bore. Then their distress usually diminishes throughout the course of the procedure.

 

Physicians can explain that patients might feel nervous or unable to complete the MRI scan at the beginning, but that once they’re through that portion of the scan, they’ll likely begin to feel more calm.

 

However, patients should know that technologists are aware of the patient’s experience, and are committed to keeping them comfortable. Imaging staff listen for verbal cues of patient anxiety — from an explicit admission of fear to a tremor in the voice — and will move quickly to help a patient through a moment of panic.

 

Technologists also watch their patients’ eyes; people with claustrophobia might glance nervously at the scanner’s bore or else avoid looking at the machinery altogether. Other indications of anxiety that technologists watch for include blanching or flushing in the patient’s face; reluctance to follow simple instructions; sweating; or reports of tachycardia.

 

Physicians can help to prepare nervous patients for a better experience at the imaging center by assuring them that the imaging staff is aware of, and responsive to, any discomfort they might feel, and that they will pause the procedure at the patient’s request.  

 

  1. Patients should know that the choice to go through with an MRI scan is entirely within their power; technologists will never try to coerce them to go through with a procedure they decide to delay.

 

Ultimately, health care choices belong to the patient. If patients express anxiety about an upcoming MRI scan, physicians can assure them of this fact. They can explain that the patient can choose to forego a scan at any point during the treatment process.

 

By including this comforting information in an explanation of the health benefits of the MR images, physicians both place the nexus of control within the patient while also gently encouraging them to undergo the procedure for the sake of their health.   

 

  1. Technologists provide detailed, thorough explanations to patients before entering the examination room.

 

Patients who know what to expect are less likely to become anxious. But technologists also use their pre-scan conversations to build healthy clinical relationships with patients. It’s important for patients to know that their technologists are friendly, understanding, competent, and utterly trustworthy. Early conversations help to create this welcoming atmosphere.

 

Physicians can lay the groundwork for a successful imaging procedure by assuring their patients of the technologist’s positive attributes. That’s why it’s so valuable for physicians to work with preferred imaging providers, building relationships and trust that they use to help reassure patients who might be uncomfortable with the procedure. It’s all part of the patient-centered approach that Precise Imaging practices.

 

  1. There are multiple distraction-based interventions that have documented history of helping patients through their anxiety when they enter the scanner bore.

 

The authors of Pinpointing Moments of High Anxiety During an MRI Examination, the study from the International Journal of Behavioral Medicine, seem hopeful about in-bore audiovisual systems that could distract patients during moments of anxiety — perhaps by allowing them to experience favorite TV shows or movies during the exam. The researchers also point to the use of prism glasses, which provide mirrors that allow patients to see outside of the bore, even as they lay flat for the procedure.

 

However, even something as simple as placing a soft cloth over the patient’s eyes can help alleviate claustrophobia, writes technologist Thomas Rotunda, BSMI, BSHA, R.T.(R)(MR)(QM), in a recent edition of the journal Radiologic Technology.

 

This practice “is a basic way to combat claustrophobia because it helps patients ignore how close the inside of the scanner is to their faces, which likely makes them feel less confined,” Rotunda writes.

 

  1. Newer scanning technology can be incredibly effective in reducing claustrophobia among patients.

 

One of the most powerful changes that imaging centers can make is to update their equipment, and that’s been true for a decade. A seminal 2007 study in the Journal of Magnetic Resonance Imaging found that the latest MRI scanners, which reduced noise in-bore noise by 97 percent while also featuring a shorter bore than previous models, could reduce the incidence rate of claustrophobia by three times.

 

Physicians can reduce the expectation of anxiety in their patients by explaining the changes that have taken place since the old days of narrow bores and loud machines. Managing patient expectation will go a long way toward reducing claustrophobia and anxiety, which will lead to greater outcomes for patients.

 

Call Precise Imaging at 800-558-2223 to discuss advanced imaging equipment available and anxiety-reduction options, or to make a referral.

 

References:

 

Dewey M, Schink T, Dewey C. Claustrophobia During Magnetic Resonance Imaging: Cohort Study in Over 55,000 Patients. Journal of Magnetic Resonance Imaging. November 2007; 26(5):1322-1327. Available from: Wiley Online Library. Accessed November 2, 2017.

 

Melendez J, McCrank E. Anxiety-related reactions associated with magnetic resonance imaging examinations. JAMA, The Journal Of The American Medical Association [serial online]. 1993;(6):745. Available from: General OneFile, Ipswich, MA. Accessed November 2, 2017.

 

Minde D, Klaming L, Weda H. Pinpointing Moments of High Anxiety During an MRI Examination. International Journal Of Behavioral Medicine [serial online]. June 2014;21(3):487-495. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 2, 2017.

 

Rotunda T. Reducing Occurrences of MR-related Claustrophobia in Patients With PTSD. Radiologic Technology [serial online]. September 2017;89(1):97-99. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 2, 2017.

 

Medical Imaging for Personal Injury Claims Involving Car Accidents

13 Oct 2017 Facilities, MRI, Personal Injury

Medical Imaging for Personal Injury Claims Involving Car Accidents

 

Personal injury claims require a serious burden of proof, and medical imaging can be the case-deciding factor. Even when doctors decline to order MRI scans, lawyers themselves can sometimes schedule a diagnostic imaging procedure for their clients.

 

Here’s what attorneys should know about pursuing medical imaging procedures for their patients who have been injured in at-fault car accidents:

 

 

Some MRI scans do not require a physician’s referral.

 

 

You can divide MRI scans into two general categories: those that require an intravenous contrast agent, typically a harmless element called gadolinium, and those that don’t. The former do require a doctor’s order, but a simple MRI scan, without the use of contrast agent, may not require an initial doctor’s referral

 

 

Most other medical imaging procedures do require a doctor’s recommendation.

 

 

Many of the leading technologies radiologists use to diagnose injuries and illnesses expose patients to a small dose of ionizing radiation. It’s small, but over a patient’s lifespan, the exposure accumulates. That’s why radiologists generally do require a physician’s referral before proceeding with tests such as X-rays, CT scans, and arthrograms.

 

 

Doctors often order MRI scans in cases of suspected cases of spinal injury and soft tissues.

 

 

MRI scans are particularly well-suited to imaging soft tissues, such as ligaments, muscles, and nerves. Injuries associated with car accidents — including whiplash and herniated discs — often involve these soft tissues. So this imaging modality is particularly well suited to common injuries that result from car accidents.

 

 

Rear-end collisions frequently lead to whiplash and spinal cord injuries.

 

 

When one driver rear-ends another, causing injury, half of the attorney’s job is already done: It’s usually simpler to assign fault in rear-end collision cases.

 

However, they still have to convince the judge that the patient was truly injured. Because this type of wreck often leads to soft-tissue injuries, MRI scans might be the ideal imaging modality to show to prove the negative effect of the accident on the plaintiff’s health.

 

 

Precise Imaging can provide MRI scans on a tight deadline.

 

 

Some personal injury attorneys spend hours calling around to diagnostic imaging providers, looking for a quick MRI before a case goes to court. The better solution would be to rely on a consistent resource with an imaging provider that understands the role of diagnostic imaging in legal cases — a provider like Precise Imaging.

 

Precise Imaging has experience serving attorneys and their clients in the Los Angeles area and beyond. We offer specialized resources just for attorneys, and accept personal injury liens as well as letters of protection. There’s even a dedicated web portal just for attorneys, complete with 24/7 IT support.

 

We also understand that, in law, timing is of the essence. That’s why Precise Imaging’s locations offer expedited, 24-hour service on radiology reports with tight deadlines.    

 

The next time you file a personal injury claim for a client who was injured in a car accident, remember the value of diagnostic MRI scans. Call Precise Imaging at 800-558-2223 to learn more.

  

 

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