Referring provider newsletter

VOLUMETRIC MRI IMAGING
NeuroQuant®
Referring
provider
newsletter
CorTechs Labs, Inc
1020 Prospect St., #450
La Jolla, Ca, 92037
Tel:(858)459-9700
Windsong Neuroradiologist Igor Mikityansky, MD, is offering a quantitative tool used to diagnose and
evaluate Neurodegenerative Disorders such as Alzheimer’s Disease and Dementia
General Morphometry Report
PATIENT INFORMATION
A proprietary MRI software package
evaluates and analyzes the patient’s MRI
for brain atrophy and compares the result to the only FDA-approved database
of people of the same age that have
normal healthy brains. The Age-Related Atrophy Report provides the absolute and relative volumes of the inferior
lateral ventricles and the hippocampus
structures that typically show atrophy in
dementia patients. The information and
data can be used as an early warn-
ing for patients that
have Mild Cognitive
Impairment (MCI) as
studies have shown
that patient’s with a
small hippocampus
are four times more
likely to progress to
Alzheimer’s disease
that those with a normal size hippocampus.
Patient Name:
Smith, John Jr.
Sex:
M
Accession Number:
093951_1
Referring Physician:
Jones, Steven MD,PhD
Exam Date:
2006/02/22 10:18:17 AM
MORPHOMETRY RESULTS
Celebrating 26 Years of Imaging Excellence
LH Volume (cm³)
LH Volume
(% of ICV)
RH Volume (cm³)
RH Volume
(% of ICV)
Forebrain Parenchyma
520.22
31.02
491.11
29.28
5.76
Cortical Gray Matter
264.68
15.78
237.58
14.16
10.79
Lateral Ventricle
25.11
1.50
31.11
1.85
-21.34
Inferior Lateral Ventricle
2.31
0.14
2.53
0.15
-9.09
Brain Structure
Hippocampus
The referring physiAmygdala
cian will have access
Caudate
to an Age-Related
Putamen
Pallidum
Atrophy Report and
Thalamus
a General MorphomCerebellum
etry Report that will
provide the absolute
and relative volumes
for brain structures that also contains an
Asymmetry Index which is defined as the
difference between left and right volumes and divided by the mean. Also
available to the doctor will be a color-coded brain segmentation as a separate 3D MR series on a PACS or DICOM
viewer as well as a coronal loop ‘mov-
Asymmetry Index
(%)*
2.81
0.17
3.12
0.19
-10.25
1.02
0.06
1.28
0.08
-22.72
3.83
0.23
3.79
0.23
1.10
4.67
0.28
4.41
0.26
5.59
0.89
0.05
0.85
0.05
4.60
8.72
0.52
8.12
0.48
7.09
58.25
3.47
57.61
3.44
1.10
*The Asymmetry Index is defined as the difference between left and right volumes divided by their mean (in percent)
ie’ of the color-coded segmented brain
that can be viewed in QuickTime or Windows Media Player.
The volumetric MRI study performed at
Windsong Radiology Group is then read
by our fellowship trained Neuroradiologist, Igor Mikityansky, MD.
© CorTechs Labs, Inc. | www.cortechslabs.com
New Windsong Radiologist to Offer
Special Interventional Procedures
Windsong Radiology Group is proud
to announce that Jason Dana
Dunleavy, M.D. recently joined our
practice on February 11th. Most
recently, Dr. Dunleavy practiced
in the fields of Interventional and
Diagnostic Radiology for a large
group in Elmira, New York.
Dr.
Dunleavy
has
family
in Central New York and
spent summers with friends
on Chautauqua Lake.
He
is an avid skier and while in
college competed on the
Division I Alpine Ski Team.
He was the 1994-1995 Junior
Olympic Alpine Ski Champion
and
competed
in
the
1995 Swedish Alpine Skiing
National Championship.
Special Procedures List
Dr. Dunleavy will be offering the following procedures at
Windsong Radiology Group in Williamsville:
Dana Dunleavy, MD
Nuclear Medicine
New Hours
• Assessment and treatment of varicose veins including:
Monday & Tuesday
7:30 am - 7:00 pm
•Minimally invasive image guided biopsy
Wednesday - Friday
7:30 am - 4:30 pm
• Ablation
• Sclerotherapy
• Micro-phlebectomy
55 Spindrift Drive
Williamsville, NY 14221
•Paracentesis
•Thoracentesis
•Pain management
716.631.2500
•Musculoskeletal injections/aspirations
•Other image guided minimally invasive procedures.
For additional procedures not listed above or for any questions, Dr. Dunleavy can be reached at
716.631.2500, *1928, [email protected]
55 Spindrift Drive
Williamsville, NY 14221
Winter 2013
Dr.
Dunleavy
majored
in
Neuroscience
at
Middlebury
College
where
he
was
an
independent scholar. Dr. Dunleavy
completed his medical education
and internship at the University
of Vermont. He then went on to
complete a Diagnostic Radiology
Residency at the Johns Hopkins
Hospital. He stayed on at Johns
Hopkins for a Fellowship in Vascular
and
Interventional
Radiology,
serving as Chief Fellow.
Dr. Dunleavy is Board Certified
and has established extensive
research
and
publication
credentials during his entire
academic career, and most
recently was the primary
author of a chapter in a
medical
reference
book
titled “MRI for Orthopaedic
Surgeons”.
VOLUME 3 ISSUE 2
Windsong Radiology Group is excited
to offer a new quantitative tool that will
provide advanced diagnostic capabilities to help in the assessment of patients
with suspected neurodegenerative disorders such as Alzheimer’s disease, Dementia, and Mild Cognitive Impairment.
The study is essentially a volumetric MRI
that measures and automatically quantifies the volumes of the brain structures
known to deteriorate in neurodegenerative diseases such as Alzheimer’s disease. The information provided with the
MRI study helps physicians make a diagnosis and also follow the progression of
the disease.
Patient ID:
005_S_0221
Windsong Medical Park
55 Spindrift Drive
Williamsville, NY 14221
Omni Pain & Wellness Center
4855 Camp Road
Hamburg, NY 14075
windsongradiology.com
Lancaster Office
4893 Transit Road
Depew, NY 14043
Northwoods Medical
3950 E. Robinson Road
W. Amherst, NY 14228
NOVA MRA
Windsong using NOVA MRA technology to quantify the volumetric blood flow rate in the vessels
of the brain.
Windsong Radiology Group has recently
upgraded our neuroimaging services
to include NOVA® MRA (Non-invasive
Optimal Vessel Analysis) to incorporate
interactive 3D images that provides a
360° view of vasculature that allows for
precise identification of each vessel for
volumetric flow calculation.
The NOVA® neuro system has been
developed by VasSol, and primarily
focuses on the neurovascular region,
which encompasses the head and
neck. According to VasSol, specifically,
the data gathered in the NOVA®
Neuro system has proven to be highly
beneficial in diagnosing and treating
individuals who are at risk for or who
have suffered from stroke and cerebral
aneurysms, as well as those who suffer
from neurovascular disease related to
chronic medical conditions such as
heart disease and diabetes. Recently,
Windsong performed an investigational
study looking at cerebral aqueduct flow
for normal pressure hydrocephaly.
The NOVA® MRA procedure is completely
non-invasive and no contrast is needed
in most cases.
The Nova 3D model
rotates a full 360°, allowing the anatomy
to be viewed from all angles. The NOVA®
system generates data in real time and
provides volumetric flow rates, velocity,
waveforms and flow direction. One of
the primary applications for this system
has been to compare pre and post
intervention such as stents to assess the
effectiveness of treatment.
In response to the recently enacted laws
that mandate the disclosure of breast
density reporting on mammograms in
New York State, Windsong Radiology
Group along with a grant given by
Hologic® conducted a CME conference
to explain the legislation and present
additional imaging options on January
19th at Windsong’s Community Room
on 55 Spindrift Drive in Williamsville.
Approximately 110 physicians,
nurse
practitioners,
physician
assistants,
and
technologists
participated in the two hour CME
conference.
Lead Technologist Mark Gritzmacher
RT(R)(CT)(MR) and MRI Technologist
Candace Silverstein RT(R)(MR) identifying
a vessel of interest.
The Importance of
Providing Diagnosis
Codes on Imaging Rx
The Diagnosis Code
is a very important
component for the
scheduling of imaging studies according to Doreen
Bossert, Support Services Manger for
Windsong Radiology
Group. Having this
information available at the time of scheduling
will result in a more speedy
and efficient registration process when the patient arrives
at Windsong, and will also
assist in the processing of the
insurance claim for the imaging study.
Windsong has also updated
and significantly improved
the pink order forms that we
DIAGNOSIS
CODE
provide listing the majority of
the services that we provide
on the large format pads
as well as the smaller pads
provided for women’s imaging. “The new pads can be
ordered by calling us in central scheduling at 631-2500,”
according to Mary Scibetta,
Scheduling Supervisor.
windsongradiology.com
Dense Breast Education Day
CME Conference at Windsong
(716)631-2500
as screening breast ultrasound, Digital
Breast Tomosynthesis (DBT) or Breast
MRI, and at the present time there are
no large clinical trials that can provide
evidence based guidelines for additional
screening. Our goal moving forward is to
continue as patient advocates, working
collaboratively with both local and
national carriers to find solutions to this
complex issue.
The
featured
speaker
was
Christopher
Comstock,
MD,
from Memorial Sloan-Kettering
Cancer Institute in New York. Dr.
Anna Chen, Director of Women’s
Imaging at Windsong followed
Dr. Comstock, and presented
a lecture on Digital Breast
Tomosynthesis (DBT). Dr. Eve Li,
Women’s Imaging Radiologist
at Windsong later followed Dr.
Eve Li, MD, Women’s Imaging Radiologist
Chen by a providing breast cancer
at Windsong Radiology Group
case presentation lecture in which
tomosynthesis was used to help make the
Breast cancer is not a homogeneous
diagnosis.
disease, and the natural progression
of all breast cancer is not the same in
The New York State Dense Breast
every patient. The most important tool in
Legislation went into effect on January 1st.
the fight against breast cancer remains
Because it’s so new, we are all charting
early detection. The increased patient
this unknown territory together. Our goal
awareness regarding breast density
is to adhere to the law while providing
measures and the potential limitations
you and your patients the information
of mammography
Dr. Janet
H. Sung
needed to make informed decisions.
may result in the
Women’s
As outlined in the presentation the, NYS
need for additional
Imaging
law did not address needed insurance
imaging in selected
Suite
coverage for additional screening such
patients.
at Windsong
A Designated Breast Center of Excellence
DENSE BREAST SUPPLEMENTAL
IMAGING OPTIONS
Breast MRI is an additional tool, which offers
numerous advantages in the diagnosis of
breast cancer including its high sensitivity to
the detection and characterization of breast
cancers, especially in high risk patients with or
without dense breast tissue.
Breast MRI has become a routine pre-surgical
imaging evaluation for patients who are newly
diagnosed with breast cancer. Additional
tumor(s) can be found in the contralateral
breast or elsewhere within the same breast that
were not initially visualized by mammography.
DIGITAL BREAST TOMOSYNTHESIS (DBT)
DBT has been shown to be instrumental in
increasing the sensitivity of detecting cancer
in patients with heterogeneous and extremely
dense breasts. Since 2D mammography has
only an approximately 60-70% sensitivity for the
detection of breast cancer in women with dense
breast tissue, we will work to expand insurance
coverage for this important imaging technology.
A two-dimensional digital mammogram has
limitations in a dense breast, in that dense tissues
can overlie on top of one another and potentially
hide small cancers. The main advantage of 3D
digital mammography is that it can reveal the
inner structure of a breast, free from overlying
dense tissue. Tumors can be found in an earlier
stage. There may also be fewer false positives,
which should reduce the number of unnecessary
breast biopsies. DBT is particularly helpful for
women with dense breast tissue or those with
high risk of breast cancer such as those with a
strong family history of breast cancer.
BREAST ULTRASOUND
Breast ultrasound is an adjunctive, non-invasive
tool to evaluate and visualize specific areas of
concern. Breast ultrasound does not replace the
need for mammography, and currently there is
no code for “screening ultrasound.”