IN THE NEWS
Inside View - Fall 2018

In This Issue

  • PROSTATE MRI MAY DETECT MORE EARLY STAGE CANCERS
  • CONTRAST REACTION — TRAINING PUTS PATIENT SAFETY FRONT AND CENTER.
  • WHAT YOU NEED TO KNOW ABOUT BREAST DENSITY: EARLY DETECTION BEGINS WITH MAMMOGRAPHY — THE ONLY SCREENING TOOL PROVEN TO REDUCE BREAST CANCER DEATHS.
  • WE’RE GROWING IN THE SPOKANE VALLEY

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WE’RE GROWING IN THE SPOKANE VALLEY

December 2018 — Our imaging center at the Providence Medical Park in Spokane Valley is in the process of receiving some significant technology upgrades, not available anywhere else in the valley, in order to better serve the patients and health care providers in this
growing area.

The improvements include the installation of a new 80 slice CT scanner and a state of the art, wide-bore, 3T (Tesla) MRI scanner that will be installed in early December.

WHAT YOU NEED TO KNOW ABOUT BREAST DENSITY: EARLY DETECTION BEGINS WITH MAMMOGRAPHY — THE ONLY SCREENING TOOL PROVEN TO REDUCE BREAST CANCER DEATHS.

November 2018 — What is Breast Density?

Breast density refers to how your breast appears on a mammogram and NOT the way it feels or its external appearance. Breasts are primarily made up of fat and fibroglandular tissue, which includes the network of glands and ducts that produce and transport milk to the nipple for breast feeding. The more fibroglandular tissue you have compared to fat, the denser your breast will appear on the mammogram. Breast density tends to decrease gradually with age, particularly around the time of menopause. Breast density is also influenced by other factors, such as weight gain/loss and certain pharmaceutical drugs.

Why is Breast Density Important?
Breast density is perfectly normal. However, high breast density is a risk factor for developing cancer, similar to family history. Breast density also plays a significant role in the ability to detect early breast cancer, because it can make it more difficult for radiologists to spot a cancer on your mammogram. Dense tissue appears white on a mammogram and many cancers also appear as white. The denser your breasts, the whiter your mammogram will look. Imagine trying to find a snowball in a snowstorm. As a result, mammograms are less accurate for women with dense breasts.

Will I Need an Additional Screening Test if I Have Dense Breasts?
We know that breast density reduces the ability to detect cancers on mammography. Breast density assessment is used to help identify women for whom the mammogram may not be enough and who may benefit from additional screening, such as breast tomosynthesis (3D mammography), whole breast ultrasound, breast MRI, or molecular breast imaging. With consistent assessment of breast density, your doctor can confidently recommend additional screening, as needed.

What Should I Do?
If you have dense breasts, talk to your doctor. Together, you can decide which, if any, additional screening tests may be right for you. Discuss your medical and family history and any other factors that might increase your risk of developing breast cancer.
Even if you are at low risk, and have entirely fatty breasts, you should still get an annual mammogram starting at age 40 to assure you have the best chance when it comes to early breast cancer detection and treatment.

CONTRAST REACTION — TRAINING PUTS PATIENT SAFETY FRONT AND CENTER.

November 2018 — At Inland Imaging, ensuring patient safety is an essential cornerstone in our pursuit to deliver Answers You Can Trust, and Care You Can Count On.
Today, nearly half of the approximately 76 million CT and 34 million MRI exams performed each year include the use of intravenous contrast agents. Contrast agents are generally injected and
eliminated from the body without any side effects or complications.

We know that a small percentage of patients may experience reactions to contrast agents. The vast majority of reactions are quite mild and resolve quickly, such as hives or a rash, but some can be potentially serious. The occurrence of these sorts of reactions is low for both CT and MR imaging. Since reactions sometimes do occur, rapid evaluation and treatment of them requires well-trained personnel and appropriate, readily available equipment and medications.
Right Assessment, Right Tools, Right Treatment.

Identifying patients likely to be prone to a reaction to contrast agents is done before these examinations are performed, but when an unexpected adverse event arises, knowing the types of reactions that can occur and delivering prompt, appropriate treatment are critical.
To that end, Inland Imaging radiologists Dr. Julie Kaczmark, Dr. Robin Hines and Dr. Sadaf Zaidi have created a hands-on training program, including the production of training videos to help provide instruction for each of our technologists, nurses, and physicians to help them stay at the top of their games when it comes to assessing and treating contrast reactions.

The videos walk viewers through a series of typical contrast reaction scenarios introducing them to the symptoms and steps necessary to make a proper diagnosis and deliver the right treatment in a timely and appropriate manner. The videos, shot at Sacred Heart Medical Center’s Dr. James Mounsey Clinical Simulation Lab, focus on teamwork and feature scenarios that each individual may encounter in actual practice. The Sim Lab allows health care professionals to practice their technical skills on high-tech robotic mannequins before treating actual patients. The mannequins are able to produce vital signs, show symptoms, and reply to questions (with a little help from the lab’s professional staff) so that the individuals being trained can assess each scenario and determine what steps, including the administration of drugs, should happen next.

PROSTATE MRI MAY DETECT MORE EARLY STAGE CANCERS

October 2018 — According to a study recently published in the New England Journal of Medicine, Magnetic Resonance Imaging (MRI), before a prostate biopsy is more likely to find early stage cancers than a standard ultrasound guided biopsy.
Five hundred men with test results indicating the possibility of prostate cancer participated in the trial. 28 percent of the participants had MRI results that detected no prostate cancer, so they did not undergo a biopsy. Prostate cancer was detected in 38 percent of the men who received an MRI-targeted biopsy, as compared with 26 percent from the
group who received a standard ultrasound
guided biopsy.

Using an MRI to identify suspected cancer in the prostate and performing a prostate biopsy targeted to the MRI information, leads to more cancers being diagnosed. Early detection can mean earlier and more effective treatment for men facing prostate cancer. To learn more, ask your primary care provider if a pre-biopsy MRI scan of the prostate might be right for you.

NEW STUDY SAYS ANNUAL SCREENING MAMMOGRAMS STARTING AT AGE 40 OFFER WOMEN THE BEST CHANCE TO BEAT BREAST CANCER.

A study recently published in the Journal of the American College of Radiology suggests that annual screening mammograms beginning at age 40 provide women the best chance at finding, treating and surviving breast cancer, says Dr. Robert Arnett, a breast imaging specialist with Inland Imaging in Spokane. “The evidence is clear, and we want to make sure that women understand that they really can make a difference in their own health by having an annual screening mammogram once they turn 40,” said Arnett.

The study was conducted by Samir B. Patel, MD, of Elkhart General Hospital in Elkhart, Indiana. Dr. Patel compared overall stage I to IV mortalities of patients diagnosed with breast cancer between 2010 and 2014 in an effort to discern which national screening guidelines offer women the best odds of overcoming the disease.

The American College of Radiology (ACR), as well as the Society of Breast Imaging (SBI) and the National Comprehensive Cancer Network (NCCN), recommend annual screening mammography for women after they turn 40 years old.

The U.S. Preventative Services Task Force, American College of Physicians and American Academy of Family Physicians suggest biennial screening for women between 50 and 74 years of age. The American Cancer Society and American Society of Breast Surgeons strongly recommend screening mammography annually between 45 and 54 years old, at which point women are urged to switch to biennial exams.

Data from computer models comparing different screening mammography recommendations show the greatest mortality reduction among those receiving screening mammograms beginning at age 40.

Among the organizations offering recommendations, the study’s author found that annual screening mammograms commencing at age 40 as recommended by the ACR, SBI and NCCN had the lowest rate of invasive cancers. It also had the lowest mortality rates across the board, with five-year risk of death reaching just 10.1 percent.

According to the study, women who received annual screening exams saw a 37.3 percent reduced overall mortality rate compared to those who had a mammogram just every other year.

“Based on stage at diagnosis, the greatest mortality reduction is achieved with mammography utilization starting at the age of 40,” Patel wrote. “The results of this study are relevant to individual healthcare providers, medical groups, hospitals, health systems, administrators, policy makers and patients for a greater understanding of the potential impact of following the various national mammography guidelines from a population health perspective, because healthcare is moving toward more transparent, population value-based care.”

For more information or to schedule an annual screening mammogram, go to inlandimaging.com/breast-imaging or call (509) 455.4455.

EXPANDING CAPABILITIES IN THE VALLEY

Construction began recently on an expansion at our imaging center located at Providence Medical Park in Spokane Valley. Crews are remodeling and expanding the center to make room for a new 3T MRI scanner to help serve Spokane Valley’s growing population.

The strength of an MRI scanner’s magnetic field is measured in units known as Teslas (after the famous and some would say unappreciated inventor of the same name.) The more Teslas, the higher the image quality produced by the scanner. Construction should be complete sometime in mid-December.

NEW HELP FOR ESTIMATING YOUR OUT OF POCKET IMAGING EXPENSES

We all want to know what something’s going to cost before we buy it. That’s why Inland Imaging has created a way to provide you with an estimate of the cost of your care prior to service so that you can be prepared for any out-of-pocket costs that your insurance may not cover.

Insurance benefits can be confusing. To help you understand your health plan, we contact your active insurance carrier to determine your benefits. While we can’t provide a formal guarantee of your out-of-pocket expenses, we can provide a reliable estimate based on what we are told by your insurance provider about your coverage. We understand that things can change if you have a change in treatment. That’s why we think it’s important to provide information that can help you be prepared for potential costs.

Your financial situation will never affect your ability to receive care at Inland Imaging. We are committed to making sure you receive the best care.
Our Patient Access department can assist you with any questions. Please contact us at (509) 455.4455.

Radiology Groups Come Together to Expand Imaging Services in the Inland Northwest

(Spokane and Tri-Cities, WA) March 27, 2018: Two of the most highly regarded radiology groups in the northwest are joining forces. Inland Imaging, PS, based in Spokane, and Columbia Basin Imaging (CBI), based in the Tri-Cities, are combining their professional radiology groups, effective September 2018. The new group brings together nearly 90 radiologists, making it one of the largest professional radiology practices in the Western United States.

“Combining our two groups allows us to better connect our region’s medical imaging technology, expertise, and resources so that we can continue to improve the way we serve patients and their referring physicians,” said Dr. Jayson Brower, President of Inland Imaging, PS. “This partnership allows us to promote best practices and standardization while assuring that studies are reviewed by the subspecialized radiologists best equipped to read them. The ultimate winner is the patient.”

CBI is a Tri-Cities based group of physicians who have provided radiology services at Kadlec Regional Medical Center for more than 30 years. “This partnership not only helps us better support radiology and imaging services throughout the region, it will also help promote the integration of services on the Kadlec campus by combining both interventional and diagnostic radiology services within the new group,” said Dr. Richard Nguyen, president of CBI.

“By expanding our geographic footprint to more closely match that of our important health system partner, we are able to generate more effective ways to deliver services,” said Inland Imaging CEO Steve Duvoisin. “It allows us to see the region’s healthcare resources in a more global and holistic way. That broader point of view helps us imagine new ways to raise our quality and efficiency while holding down costs by serving more patients around the region.”

Inland Imaging, PS has been operating in Spokane since 1930. The organization’s board-certified radiologists serve outpatient imaging centers, urban and rural medical centers, hospitals, clinics and private practices in Western, Central and Eastern Washington, Northern Idaho and Western Montana. In addition, the organization’s radiologists own Inland Imaging Business Associates, a company that provides various radiology business and IT services to clients throughout the Northwest.

Columbia Basin Imaging is a private practice consisting of board-certified radiologists. This group of subspecialized and general radiologists provides professional interpretations for patients of Kadlec Regional Medical Center, free-standing E.D., urgent care clinics, and physician offices. This commitment to service and subspecialization ensures that patients are always receiving the most cutting-edge medical imaging studies available today.

WE’RE EXPANDING BREAST IMAGING CAPABILITIES TO BETTER SERVE WOMEN ON SPOKANE’S NORTH SIDE

March 8, 2018 - Inland’s recently added a fourth 3D Mammography unit at our Holy Family Imaging Center in North Spokane. The additional unit, according to Marian Wilkonski, Inland Breast Imaging Manager, “means we will be able to continue to serve the needs of a growing population in the most convenient, timely and accurate way possible.” The additional capacity will mean easier and more convenient scheduling for both screening and diagnostic mammogram patients on the North side.
“We’re excited to be able to offer women greater access to this technology which is now considered the ‘gold standard’ in early breast cancer detection,” said Wilkonski.

A significant research study reported in the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION found that 3D mammography, reveals significantly more invasive cancers than a traditional, 2D mammogram. Invasive cancers are more likely to spread or cause death. 3D mammography also reduces the number of women called back for additional imaging, which reduces patient anxiety and helps lower health care costs.

Affirm Breast Biopsy System with Brevera Imaging Technology

In addition to increasing mammography capacity, Inland Imaging has also acquired the Affirm Breast Biopsy system with Brevera imaging technology. This system allows us to quickly perform breast biopsies using the same imaging equipment we use for regular mammography exams.

The Brevera system delivers essential information quickly and accurately – allowing physicians to make informed clinical decisions with confidence while saving valuable time. In addition, faster procedures can result in a more positive biopsy experience for patients as well.
“We’ve seen a growing number of patients and breast surgeons seeking access to services in North Spokane,” said Kathleen Wilson, Inland Imaging’s Chief Operations Officer. “We will continue to respond by increasing both our capacity to deliver care and access to the technology and tools we need to serve their needs.”